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Pennsylvania rates for HCPCS 50976

Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$540.00 / $2,326.00 / $7,799.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.27 / $461.09 / $587.71
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,058.35 / $6,182.00 / $17,094.48
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.06 / $648.35 / $879.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.54 / $607.51 / $947.51
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.23 / $706.67 / $706.67
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$617.00 / $2,326.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.27 / $491.19 / $2,441.69
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.00 / $621.20 / $1,134.90
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.94 / $612.96 / $1,062.14
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$448.57 / $448.57 / $679.72
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.07 / $451.73 / $679.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$814.00 / $2,391.00 / $4,789.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.11 / $580.63 / $940.90