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Massachusetts 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
$446.68 / $2,238.72 / $3,801.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $446.68 / $1,202.26
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $5,128.61 / $19,498.45
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $575.44 / $1,318.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $724.44 / $1,479.11
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $660.69 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $512.86 / $776.25
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $4,265.80 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $645.65 / $1,174.90
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $5,370.32 / $19,498.45
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $562.34 / $1,288.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $4,265.80 / $11,220.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $676.08 / $1,258.93