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Maryland 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
Professional
Modifier
Low / Median / High Price
$354.81 / $457.09 / $1,122.02
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $371.54 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $2,630.27 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $524.81 / $1,122.02
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $537.03 / $870.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $1,621.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $478.63 / $812.83
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $602.56 / $676.08