go back

Illinois 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
$537.03 / $1,862.09 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $436.52 / $831.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $7,762.47 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $575.44 / $831.76
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $660.69 / $1,995.26
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $446.68 / $588.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $4,265.80 / $7,585.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $537.03 / $912.01