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Maine 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
$363.08 / $457.09 / $812.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $549.54 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $575.44 / $776.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $562.34 / $891.25
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $549.54 / $1,412.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $588.84 / $912.01