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Maryland rates for HCPCS 50389

Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)

Facilitymedian $1,175 · 10th–90th $263–$1,1750%50%10th$1,175Professionalmedian $178 · 10th–90th $50–$7760%5%10%10th90th$178$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $1,174.90 / $1,174.90
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $257.04 / $776.25
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $56.23 / $64.57
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $165.96 / $812.83
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $489.78 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $263.03 / $707.95
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $549.54 / $676.08