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Minnesota rates for HCPCS 50130

Pyelotomy With Removal Calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$974.60 / $974.60 / $974.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$974.60 / $1,036.41 / $1,505.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,485.25 / $7,107.25 / $13,799.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,729.98 / $2,666.90 / $3,741.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,473.73 / $3,508.06 / $8,439.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,012.21 / $3,382.21 / $4,827.56
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,010.96 / $3,207.20 / $6,644.96
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,771.56 / $3,031.67 / $4,017.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,365.46 / $1,771.13 / $3,378.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,340.03 / $2,685.58 / $5,391.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,751.00 / $3,500.00 / $8,152.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.94 / $2,876.41 / $4,155.47