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Delaware rates for HCPCS 50075

Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,907.00 / $6,907.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,447.41 / $1,476.21 / $1,476.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,319.03 / $1,805.84 / $2,556.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.00 / $150.00 / $150.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,460.00 / $2,136.98 / $3,324.18