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Oklahoma rates for HCPCS 50120

Pyelotomy; with exploration

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,063.90 / $3,684.00 / $18,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,063.90 / $1,063.90 / $1,082.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$965.99 / $1,279.28 / $1,505.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$773.00 / $1,315.00 / $5,882.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$890.30 / $1,209.67 / $7,127.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$350.00 / $1,760.00 / $6,155.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$791.38 / $1,088.14 / $1,739.05