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Ohio rates for HCPCS 50389

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

Facilitymedian $1,995 · 10th–90th $389–$9,5500%5%10%10th90th$1,995Professionalmedian $182 · 10th–90th $51–$7240%10%10th90th$182$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$147.91 / $1,949.84 / $10,232.93
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $3,715.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $257.04 / $758.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $2,137.96 / $3,981.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $177.83 / $676.08
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $53.70 / $60.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $117.49 / $630.96
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $158.49 / $676.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $38.02
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $851.14
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $380.19 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $1,659.59 / $4,073.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $239.88 / $575.44