go back

Texas 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 $1,148 · 10th–90th $71$5,8880%5%10th90th$1,148Professionalmedian $126 · 10th–90th $93$2190%10%20%10th90th$126$50.0$200.0$1.0K$5.0K

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
$537.03 / $2,454.71 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $123.03 / $194.98
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $74.13 / $331.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $112.20 / $154.88
Baylor Scott & White
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $251.19 / $346.74
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $208.93
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $229.09 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $251.19
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $602.56
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,047.13 / $1,047.13
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $177.83 / $3,548.13
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $141.25 / $234.42
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $79.43
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $234.42 / $316.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $147.91 / $263.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $151.36 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $831.76 / $2,290.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $125.89 / $199.53
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $131.83 / $131.83