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Pennsylvania 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
$724.44 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $436.52 / $954.99
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $7,585.78 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $549.54 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $489.78 / $831.76
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $691.83 / $758.58
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $588.84 / $831.76
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $2,344.23 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $501.19 / $1,174.90
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $741.31 / $870.96
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $891.25 / $1,023.29
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $338.84 / $933.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $346.74 / $933.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $3,548.13 / $16,595.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $457.09 / $794.33