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Washington rates for HCPCS 50075

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

Facilitymedian $3,236 · 10th–90th $1,862–$18,6210%10%10th90th$3,236Professionalmedian $1,995 · 10th–90th $1,380–$3,7150%10%10th90th$1,995$50.0$200.0$1.0K$5.0K$20.0K

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
$2,691.53 / $3,801.89 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,862.09 / $3,630.78
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,754.23 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,754.23 / $4,265.80
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,951.21 / $3,715.35
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,951.21 / $3,715.35
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,818.38 / $2,884.03
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,995.26
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,090.30 / $4,265.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,754.23 / $3,630.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,621.81 / $5,754.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,290.87 / $3,981.07
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,737.80 / $2,630.27