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Utah rates for HCPCS 50389

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

Facilitymedian $3,020 · 10th–90th $437–$4,5710%10%10th90th$3,020Professionalmedian $178 · 10th–90th $50–$6920%10%10th90th$178$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$436.52 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $177.83 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $269.15 / $707.95
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $288.40
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,318.26 / $1,995.26
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,445.44 / $1,949.84 / $3,019.95
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $645.65
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $407.38 / $724.44
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $524.81 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $2,818.38 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $288.40 / $588.84