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Missouri 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
$493.05 / $2,832.00 / $7,365.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.20 / $402.46 / $499.73
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $4,852.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.52 / $497.40 / $760.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.05 / $603.49 / $973.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$393.86 / $667.56 / $4,332.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$499.21 / $895.89 / $5,828.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,644.00 / $2,874.00 / $5,813.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.51 / $597.19 / $1,165.92