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Missouri 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 $1,820 · 10th–90th $224–$5,6230%5%10th90th$1,820Professionalmedian $126 · 10th–90th $93–$2400%10%20%10th90th$126$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
$144.54 / $2,570.40 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $123.03 / $245.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $138.04 / $213.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $131.83 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $158.49 / $257.04
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $186.21 / $912.01
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $229.09 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $549.54 / $1,621.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $154.88 / $257.04