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Washington, DC rates for HCPCS 50130

Pyelotomy With Removal Calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,017.00 / $1,614.00 / $7,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,093.21 / $1,093.21 / $1,093.21
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,189.57 / $1,234.33 / $1,570.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,064.65 / $1,388.99 / $3,474.94
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.56 / $2,302.89 / $2,302.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.00 / $1,319.00 / $16,382.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.61 / $2,220.17 / $2,884.82