go back

Colorado rates for HCPCS 50080

Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; simple (eg, stone[s] up to 2 cm in single location of kidney or renal pelvis, nonbranching stones)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$711.13 / $3,133.00 / $7,617.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,990.00 / $19,587.00 / $44,198.00
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$711.14 / $1,101.71 / $1,375.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$854.74 / $1,053.04 / $1,353.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,128.00 / $11,924.00 / $19,737.00