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Georgia 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
$660.69 / $3,630.78 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $446.68 / $851.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $2,884.03 / $6,918.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $602.56 / $977.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $645.65 / $1,000.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $501.19 / $870.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $4,168.69 / $6,918.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $537.03 / $933.25