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Montana rates for HCPCS 50955

Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.71 / $1,847.98 / $2,254.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$545.78 / $545.78 / $545.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$545.78 / $591.89 / $707.71
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.61 / $819.00 / $836.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.16 / $549.44 / $759.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.55 / $736.80 / $1,166.43