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Illinois 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 $1,380 · 10th–90th $186–$5,6230%5%10th90th$1,380Professionalmedian $135 · 10th–90th $98–$2570%10%10th90th$135$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
$186.21 / $1,621.81 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $239.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $389.05 / $2,290.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $204.17 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $158.49 / $239.88
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $199.53 / $645.65
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $123.03 / $169.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $691.83 / $2,089.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $154.88 / $245.47