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New Jersey 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 $4,898 · 10th–90th $1,514–$10,7150%10%10th90th$4,898Professionalmedian $123 · 10th–90th $91–$2950%10%10th90th$123$100.0$500.0$2.0K$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
$1,737.80 / $5,495.41 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $123.03 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $162.18 / $380.19
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $158.49 / $239.88
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $776.25 / $1,230.27
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $141.25 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,630.27 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $120.23 / $234.42