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Missouri rates for HCPCS 50130

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

Facilitymedian $4,571 · 10th–90th $1,778–$9,5500%5%10%10th90th$4,571Professionalmedian $1,175 · 10th–90th $955–$2,2390%10%10th90th$1,175$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $4,897.79 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,174.90 / $2,511.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,786.30 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,258.93 / $2,041.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,047.13 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $1,348.96 / $2,290.87
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $1,737.80 / $9,549.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,621.81 / $7,585.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,818.38 / $7,585.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,412.54 / $2,344.23