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Minnesota 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 $407 · 10th–90th $120–$1,0960%5%10%10th90th$407Professionalmedian $229 · 10th–90th $117–$4470%5%10th90th$229$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
$91.20 / $120.23 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $213.80
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $478.63 / $1,096.48
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $257.04 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $457.09 / $1,096.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $346.74 / $537.03
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $436.52 / $851.14
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $309.03 / $489.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $199.53 / $1,737.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $269.15 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $1,819.70 / $3,715.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $239.88 / $446.68