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Wyoming 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)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.36 / $97.36 / $126.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.00 / $237.00 / $307.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.61 / $174.46 / $282.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.00 / $293.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.00 / $316.23 / $483.13