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Washington, DC 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
$463.47 / $2,080.00 / $4,100.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.67 / $369.67 / $463.47
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$381.77 / $418.34 / $5,165.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.04 / $538.47 / $1,221.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.54 / $977.18 / $977.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,832.00 / $2,343.00 / $26,408.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$404.74 / $632.40 / $1,132.22