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Oregon 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 $240 · 10th–90th $141–$5,0120%20%10th90th$240Professionalmedian $166 · 10th–90th $98–$3160%10%10th90th$166$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

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
$165.96 / $281.84 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $229.09 / $331.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $223.87 / $309.03
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $165.96 / $295.12
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $316.23
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $251.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $177.83 / $295.12
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $223.87 / $316.23
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $851.14 / $1,023.29
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $257.04 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,096.48 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $218.78 / $323.59