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South Carolina rates for HCPCS 50130

Pyelotomy With Removal Calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,257.18 / $2,844.74 / $16,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,006.73 / $1,257.18 / $2,842.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$959.64 / $1,523.00 / $2,677.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,060.41 / $1,450.67 / $2,692.41
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,006.73 / $1,392.69 / $2,280.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.60 / $972.76 / $1,599.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$659.00 / $6,107.00 / $8,818.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,013.22 / $1,398.61 / $2,644.93