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New Hampshire 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
Facility
Modifier
Low / Median / High Price
$100.00 / $1,500.12 / $8,965.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.69 / $529.52 / $1,500.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,769.10 / $5,299.00 / $8,600.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.59 / $611.79 / $881.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.36 / $869.12 / $1,410.75
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.90 / $816.10 / $1,475.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,565.00 / $9,565.00 / $9,565.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.91 / $852.94 / $1,593.53
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.99 / $335.85 / $403.02