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Utah rates for HCPCS 50075

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

Facilitymedian $4,169 · 10th–90th $2,089–$6,0260%20%10th90th$4,169Professionalmedian $1,862 · 10th–90th $1,380–$3,5480%20%10th90th$1,862$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
$2,089.30 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,548.82 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,041.74 / $3,090.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $3,548.13
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,570.40 / $6,760.83
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,630.27 / $3,981.07
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,187.76 / $5,248.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $4,466.84 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,778.28 / $3,019.95