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Idaho 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 $407 · 10th–90th $126–$5,4950%10%10th90th$407Professionalmedian $158 · 10th–90th $98–$2570%10%10th90th$158$50.0$200.0$1.0K$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
$1,412.54 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $281.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $323.59 / $741.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $199.53 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $165.96 / $218.78
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $154.88 / $302.00
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $257.04
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $549.54 / $776.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $169.82 / $208.93
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $186.21 / $436.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $8,317.64 / $9,332.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $154.88 / $229.09