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South Carolina rates for HCPCS 50391

Instlj Ther Agent Renal Pelvis&/Ureter Via Tub

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.95 / $332.25 / $9,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.54 / $122.52 / $196.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.29 / $280.37 / $434.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.45 / $122.00 / $216.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.80 / $63.80 / $81.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.82 / $160.37 / $263.08
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.47 / $168.29 / $236.32
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.44 / $56.44 / $81.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.81 / $150.60 / $237.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$358.00 / $1,221.00 / $3,585.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.41 / $169.13 / $329.30