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Tennessee 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
$575.44 / $2,137.96 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $446.68 / $794.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $5,370.32 / $9,332.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $575.44 / $977.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $3,311.31 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $524.81 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,454.40 / $14,454.40 / $19,498.45
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $6,025.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $3,630.78 / $6,309.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $549.54 / $870.96