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Michigan 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
$446.97 / $2,056.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.16 / $446.97 / $543.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,490.25 / $4,074.17 / $5,550.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.45 / $522.88 / $901.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.01 / $473.61 / $837.15
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.90 / $2,056.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.90 / $446.97 / $670.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.85 / $447.89 / $642.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,524.00 / $5,819.00 / $8,339.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$484.07 / $573.53 / $762.80