go back

Delaware 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,140.00 / $3,140.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.57 / $101.93 / $128.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.06 / $134.08 / $185.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.27 / $158.69 / $280.67