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Florida rates for HCPCS 50130

Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $5,495.41 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,096.48 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $398.11 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,412.54 / $2,454.71
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,332.54 / $21,379.62 / $33,113.11
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $724.44 / $1,122.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,348.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $5,128.61 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,230.27 / $2,187.76
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $954.99