go back

Arkansas rates for HCPCS 50957

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$482.06 / $975.00 / $2,812.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.10 / $482.06 / $575.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,782.27 / $4,782.27 / $5,738.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.53 / $467.90 / $574.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,575.46 / $2,575.46 / $2,575.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.57 / $621.00 / $803.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$980.00 / $1,650.00 / $4,064.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.10 / $656.11 / $882.61