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Utah 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
Facility
Modifier
Low / Median / High Price
$512.86 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $380.19 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $501.19 / $724.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $645.65
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $6,025.60 / $13,489.63
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $676.08 / $794.33
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $645.65 / $758.58
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $562.34 / $776.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $2,818.38 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $426.58 / $741.31