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Missouri rates for HCPCS 50130

Pyelotomy With Removal Calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,181.90 / $4,470.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$942.99 / $1,171.80 / $1,196.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.00 / $4,490.00 / $11,288.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,034.18 / $1,268.94 / $2,029.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.45 / $1,470.29 / $2,699.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$841.62 / $1,729.00 / $7,589.52
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,157.63 / $1,875.83 / $7,669.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,182.00 / $3,233.00 / $11,343.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.55 / $1,544.84 / $2,611.00