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Texas 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
$425.00 / $2,128.00 / $6,762.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,580.01 / $4,859.85 / $9,086.12
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$283.14 / $283.14 / $283.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,376.10 / $2,376.10 / $2,376.10
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,576.63 / $12,000.00 / $12,000.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$327.75 / $476.61 / $984.01
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$327.75 / $484.14 / $1,067.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$564.00 / $2,064.00 / $4,509.00