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Louisiana rates for HCPCS 50130

Pyelotomy With Removal Calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $2,562.00 / $4,050.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$948.87 / $1,625.30 / $1,745.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,386.78 / $4,977.50 / $10,923.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,368.90 / $1,454.52 / $1,883.82
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,010.47 / $1,334.79 / $1,791.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$385.00 / $1,309.00 / $7,168.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$925.07 / $1,292.60 / $2,176.03