go back

Utah 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
$660.69 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $501.19 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $630.96 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $912.01
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,244.36 / $8,511.38 / $19,952.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $891.25 / $1,698.24
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $851.14 / $977.24
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $741.31 / $1,023.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $549.54 / $977.24