go back

Kansas 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
$1,361.00 / $3,506.00 / $10,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.63 / $142.06 / $199.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.76 / $167.76 / $211.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.35 / $163.98 / $234.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.55 / $170.47 / $526.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.61 / $190.00 / $933.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.00 / $526.00 / $1,769.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.99 / $157.77 / $259.22