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Idaho rates for HCPCS 50120

Pyelotomy W/Exploration

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $5,519.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,212.96 / $1,234.29 / $2,152.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,331.99 / $1,630.53 / $1,820.38
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,078.39 / $1,886.09 / $2,282.00
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,520.03 / $1,612.15 / $1,842.46
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $1,329.08 / $1,672.07
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,447.03 / $1,447.03 / $1,776.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,700.00 / $15,298.00 / $26,104.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$989.22 / $1,323.42 / $2,028.35