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Nationwide rates for HCPCS 50391

Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent)

Facilitymedian $2,692 · 10th–90th $151$8,3180%10%10th90th$2,692Professionalmedian $135 · 10th–90th $98$3090%20%40%10th90th$135$0.1$2.0$50.0$1.0K$20.0K$500.0K

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
$173.78 / $2,818.38 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $263.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $3,715.35 / $9,549.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $151.36 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $354.81 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $169.82 / $346.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $1,000.00 / $3,311.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $144.54 / $263.03