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Montana rates for HCPCS 50130

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

Facilitymedian $1,778 · 10th–90th $1,738–$4,5710%50%10th90th$1,778Professionalmedian $1,479 · 10th–90th $1,047–$2,6920%20%10th90th$1,479$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,348.96 / $3,388.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,621.81 / $1,737.80
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,778.28 / $1,949.84
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,778.28 / $1,949.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,479.11 / $2,041.74
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,174.90 / $2,238.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,778.28 / $2,818.38