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Indiana 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
$327.52 / $496.63 / $5,634.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.52 / $401.62 / $484.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,682.00 / $3,950.00 / $15,727.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.22 / $593.72 / $922.08
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.58 / $487.55 / $716.99
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.99 / $512.34 / $709.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,379.37 / $3,379.37 / $3,379.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.90 / $537.22 / $935.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,364.00 / $6,094.00 / $10,413.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.78 / $515.02 / $1,169.18