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Montana 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
$448.71 / $1,876.96 / $1,876.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$553.66 / $553.66 / $553.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$421.85 / $553.66 / $601.21
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.08 / $674.70 / $687.53
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.12 / $504.23 / $727.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.38 / $610.07 / $966.62