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Wisconsin 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
$315.89 / $799.38 / $1,894.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,479.00 / $9,096.00 / $15,579.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.76 / $1,184.66 / $1,910.81
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.81 / $426.34 / $620.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.81 / $609.44 / $8,384.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$283.45 / $426.34 / $620.21
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.96 / $988.48 / $1,379.74
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,555.63 / $2,555.63 / $2,555.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,614.00 / $6,477.00 / $8,384.00