go back

Kentucky 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
$851.14 / $2,818.38 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,174.90 / $1,479.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,128.31 / $10,715.19 / $13,182.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,122.02 / $1,513.56
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $1,288.25 / $1,548.82
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,348.96 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,698.24 / $6,309.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $4,466.84 / $30,199.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,348.96 / $2,041.74