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Pennsylvania 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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $2,691.53 / $8,317.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $2,691.53 / $57,543.99
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $2,344.23 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $794.33 / $812.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $389.05 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $2,754.23 / $10,964.78