go back

Utah rates for HCPCS 50389

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $263.03 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $302.00 / $741.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $288.40
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,122.02 / $2,630.27
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,412.54 / $1,698.24 / $3,981.07
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $128.82 / $645.65
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $371.54 / $912.01
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $524.81 / $758.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $2,818.38 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $288.40 / $588.84