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Maine 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)

Professionalmedian $148 · 10th–90th $102–$2400%10%20%10th90th$148$100.0$200.0$500.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $218.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $158.49 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $169.82 / $275.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $158.49 / $239.88
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $131.83 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $257.04