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Indiana 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 $4,074 · 10th–90th $158–$8,3180%10%10th90th$4,074Professionalmedian $123 · 10th–90th $91–$2340%10%20%10th90th$123$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$109.65 / $1,380.38 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $123.03 / $239.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,466.84 / $8,709.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $123.03 / $181.97
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $97.72 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $138.04 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $144.54 / $263.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $2,238.72 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $134.90 / $223.87