go back

Virginia 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
$1,652.72 / $4,796.00 / $9,539.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,375.44 / $1,652.72 / $1,804.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,671.00 / $14,927.78 / $20,791.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,329.18 / $1,699.73 / $2,331.17
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,671.31 / $1,944.29 / $3,385.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,461.84 / $1,953.22 / $3,626.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,376.11 / $1,651.33 / $2,036.64
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,556.40 / $2,030.99 / $2,810.70
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,836.00 / $2,035.00 / $3,378.36
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,426.49 / $1,946.43 / $3,494.66
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,426.49 / $1,946.43 / $3,494.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,713.00 / $3,295.00 / $5,790.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,253.81 / $1,930.86 / $3,149.82