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New Mexico 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 $204 · 10th–90th $135–$7,7620%10%10th90th$204Professionalmedian $126 · 10th–90th $98–$2400%10%20%10th90th$126$20.0$100.0$500.0$2.0K

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
$134.90 / $204.17 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $239.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $151.36 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $158.49 / $223.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $177.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $173.78 / $316.23
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $169.82 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $1,096.48 / $1,412.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $165.96 / $251.19