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Indiana rates for HCPCS 50130

Pyelotomy With Removal Calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$961.69 / $1,212.14 / $4,846.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.69 / $1,026.84 / $1,355.99
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,091.00 / $15,580.56 / $24,062.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,083.55 / $1,386.80 / $1,913.78
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$996.76 / $1,407.20 / $2,110.80
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$985.04 / $1,219.57 / $1,688.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$964.58 / $1,361.33 / $2,228.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,403.00 / $5,242.00 / $10,843.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$990.35 / $1,210.39 / $2,085.71