go back

Nebraska 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
$1,905.46 / $7,943.28 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,096.48 / $5,495.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $12,589.25 / $24,547.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,548.82 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $2,344.23 / $3,162.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,778.28 / $9,549.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $2,137.96 / $7,585.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,398.83 / $3,162.28
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,238.72
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $1,862.09 / $2,570.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $4,570.88 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,995.26 / $2,570.40