Ileal conduit and ureter X-ray imaging with contrast injection

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HB Injection for Ureter Xray/Ureteropyelography

Payers reporting CPT 50690

Payer pricing summary

Low

Average

$875

Median

$489

High

$8.9k

Payer rate distribution

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#
1	UnitedHealthcare case rate · outpatient · +34 other terms	397	$1.7k	$2.0k	$1.7k	85%	4–40	$1 – $22.4k
2	Humana fee schedule · outpatient · +29 other terms	132	$113	$608	$1.6k	255%	1–10	$1 – $12.8k
3	Aetna case rate · outpatient · +34 other terms	268	$2.9k	$2.9k	$1.6k	57%	—	$105 – $16.8k
4	Cigna case rate · outpatient · +28 other terms	123	$7.5k	$10.8k	$9.4k	88%	—	$1 – $40.7k
5	Oscar case rate · outpatient · +19 other terms	122	$2.6k	$2.6k	$724	28%	—	$990 – $7.5k
6	Blue Cross Blue Shield facility · fee schedule · outpatient · +33 other terms	117	$233	$647	$1.7k	263%	—	$0 – $19.5k
7	Anthem fee schedule · outpatient · +21 other terms	100	$170	$250	$206	83%	—	$67 – $2.0k
8	Molina case rate · outpatient · +27 other terms	87	$1.9k	$2.2k	$887	40%	—	$108 – $3.2k
9	MultiPlan fee schedule · outpatient · +23 other terms	62	$524	$579	$520	90%	—	$1 – $2.2k
10	Kaiser fee schedule · outpatient · +22 other terms	53	$118	$229	$222	97%	—	$20 – $1.4k
11	Healthcare Highways case rate · outpatient · +4 other terms	39	$5.8k	$8.6k	$5.4k	63%	—	$2.1k – $14.6k
12	WellCare fee schedule · both · +19 other terms	36	$65	$82	$50	61%	—	$0 – $230
13	Highmark facility · fee schedule · outpatient · +19 other terms	35	$88	$784	$1.0k	130%	—	$45 – $3.8k
14	Amerihealth Caritas facility · fee schedule · outpatient · +13 other terms	34	$56	$98	$149	151%	—	$48 – $747
15	First Health fee schedule · outpatient · +21 other terms	33	$412	$1.5k	$2.3k	155%	—	$75 – $7.2k
16	Superior Healthplan case rate · outpatient · +4 other terms	33	$948	$942	$9	1%	—	$929 – $948
17	Aetna Better Health fee schedule · outpatient · +17 other terms	26	$73	$105	$80	77%	—	$54 – $411
18	Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges	26	$461	$247	$202	82%	—	$21 – $498
19	Medica case rate · outpatient · +18 other terms	26	$1.3k	$1.1k	$677	60%	—	$320 – $2.9k
20	Optum fee schedule · outpatient · +20 other terms	24	$68	$78	$60	76%	—	$39 – $391
21	Tricare facility · fee schedule · outpatient · +15 other terms	24	$544	$2.4k	$9.2k	384%	—	$31 – $50k
22	Caresource fee schedule · outpatient · +17 other terms	23	$1.2k	$1.0k	$411	39%	—	$1 – $1.2k
23	Bcbs La fee schedule · outpatient · +3 other terms	22	$177	$255	$233	91%	—	$65 – $1.0k
24	Medicaid fee schedule · outpatient · +14 other terms	22	$50	$146	$169	116%	—	$1 – $532
25	Devoted fee schedule · outpatient · +14 other terms	21	$118	$103	$22	22%	—	$68 – $118

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