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Montana rates for HCPCS 50953

Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $676.08 / $741.31
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $524.81 / $758.58