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Ohio 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)

Facilitymedian $6,607 · 10th–90th $1,660–$13,8040%10%10th90th$6,607$100.0$500.0$2.0K$10.0K

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
$1,513.56 / $6,760.83 / $12,022.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $5,888.44 / $30,199.52
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $707.95 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $10,715.19 / $21,379.62
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $11,748.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $7,244.36 / $13,489.63