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Utah rates for HCPCS 50130

Pyelotomy With Removal Calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,467.27 / $3,038.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,317.70 / $1,467.27 / $2,341.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,239.36 / $1,471.36 / $2,235.32
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.79 / $749.63 / $989.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,337.22 / $2,002.74 / $2,356.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,312.00 / $2,446.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984.39 / $1,305.92 / $2,147.75