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Mississippi 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
$776.25 / $1,819.70 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,096.48 / $2,754.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,000.00 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,621.81 / $2,454.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $1,445.44 / $4,073.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,318.26 / $2,290.87