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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
$442.85 / $2,800.00 / $6,915.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.01 / $442.85 / $1,044.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$787.78 / $3,640.00 / $8,545.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$381.42 / $584.99 / $1,126.15
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$654.32 / $719.87 / $1,105.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,185.25 / $3,185.25 / $3,185.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.00 / $658.49 / $1,087.29
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$394.16 / $514.13 / $1,350.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $4,826.00 / $7,889.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$444.19 / $659.27 / $1,126.43