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Washington, DC 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 $2,754 · 10th–90th $135–$4,0740%10%20%10th90th$2,754Professionalmedian $132 · 10th–90th $100–$3090%20%10th90th$132$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
$134.90 / $2,754.23 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $309.03
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $562.34 / $3,235.94
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $354.81
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $141.25 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $549.54 / $1,548.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $154.88 / $288.40