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Louisiana 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
$470.99 / $1,230.00 / $3,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$392.41 / $560.02 / $715.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,153.11 / $5,491.37 / $9,832.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466.18 / $583.75 / $709.78
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.71 / $505.99 / $716.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$746.00 / $2,415.00 / $6,585.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.36 / $583.22 / $1,025.33