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Michigan 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 $2,042 · 10th–90th $158–$4,8980%20%10th90th$2,042Professionalmedian $126 · 10th–90th $95–$2040%10%20%10th90th$126$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$158.49 / $2,041.74 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $173.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $144.54 / $144.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $199.53 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $131.83 / $169.82
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $2,041.74 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $144.54 / $234.42
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $128.82 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $794.33 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $144.54 / $194.98