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Arizona 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 $2,138 · 10th–90th $158–$5,6230%5%10%10th90th$2,138Professionalmedian $126 · 10th–90th $95–$3090%10%10th90th$126$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
$1,445.44 / $3,090.30 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $323.59
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $239.88 / $446.68
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $107.15 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $138.04 / $239.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $147.91 / $1,584.89
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $158.49 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $933.25 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $123.03 / $218.78