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Utah rates for HCPCS 50075

Nephrolithotomy Rmvl Large Staghorn Calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,073.42 / $3,038.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,853.71 / $2,073.42 / $3,302.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,748.34 / $2,069.30 / $3,149.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.79 / $1,055.98 / $1,375.76
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,882.03 / $2,833.42 / $3,333.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,292.00 / $4,455.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.30 / $1,515.60 / $3,031.20