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California 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 $4,365 · 10th–90th $1,122$13,1830%10%10th90th$4,365Professionalmedian $148 · 10th–90th $98$4470%10%10th90th$148$50.0$200.0$1.0K$5.0K$20.0K

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
$1,548.82 / $5,888.44 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $134.90 / $512.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $4,466.84 / $12,882.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $181.97 / $380.19
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $1,000.00 / $2,041.74
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $181.97 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $63.10 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $147.91 / $323.59
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $120.23 / $181.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $131.83 / $239.88
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $602.56
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,047.13 / $1,047.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $177.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $158.49 / $245.47
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $147.91 / $309.03
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $407.38
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $154.88 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $1,548.82 / $6,456.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $309.03