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New York 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 $3,090 · 10th–90th $166$7,4130%10%10th90th$3,090Professionalmedian $135 · 10th–90th $98$3630%20%10th90th$135$50.0$200.0$1.0K$5.0K$20.0K

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 / $2,884.03 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $134.90 / $398.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $3,630.78 / $5,011.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $316.23
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $4,073.80
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $3,801.89 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $213.80 / $467.74
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $112.20 / $323.59
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $181.97 / $263.03
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $165.96 / $263.03
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $173.78 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $2,454.71 / $4,897.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $147.91 / $363.08
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $354.81
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $162.18 / $338.84