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Missouri rates for HCPCS 50120

Pyelotomy; with exploration

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,110.00 / $4,470.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$866.88 / $1,077.17 / $1,099.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.00 / $4,490.00 / $11,288.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.59 / $1,167.11 / $1,866.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$842.56 / $1,351.04 / $2,481.65
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$850.02 / $1,607.03 / $6,986.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,063.58 / $1,724.44 / $7,127.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.00 / $3,233.00 / $11,343.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$989.22 / $1,310.05 / $2,175.01