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Pennsylvania rates for HCPCS 50961

Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$418.56 / $2,070.00 / $7,629.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,092.00 / $7,463.00 / $11,048.00
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.00 / $2,266.00 / $8,017.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$305.51 / $376.65 / $1,045.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00