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West Virginia 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
$331.13 / $398.11 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $407.38 / $660.69
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $371.54 / $457.09
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $524.81 / $6,025.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $15,135.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $457.09 / $758.58