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Tennessee rates for HCPCS 50130

Pyelotomy With Removal Calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,821.00 / $2,829.62 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$995.59 / $1,278.65 / $2,338.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,428.00 / $2,387.00 / $4,670.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$962.40 / $1,294.27 / $2,299.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$995.02 / $1,443.19 / $2,269.21
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $9,397.76 / $9,603.68
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,505.04 / $7,669.52 / $8,560.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $2,486.00 / $4,918.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,003.00 / $1,476.95 / $2,431.94