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West Virginia 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 $117 · 10th–90th $93–$1,4130%20%10th90th$117Professionalmedian $117 · 10th–90th $91–$2040%20%10th90th$117$50.0$100.0$200.0$500.0$1.0K

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
$93.33 / $117.49 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $117.49 / $169.82
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $125.89
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $165.96 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $691.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $131.83 / $213.80