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Maine rates for HCPCS 50972

Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $446.68 / $794.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $537.03 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $512.86 / $776.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $478.63 / $707.95
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $489.78 / $1,122.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $512.86 / $776.25