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South Dakota 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 $2,344 · 10th–90th $661–$17,7830%20%10th90th$2,344Professionalmedian $1,349 · 10th–90th $955–$1,5140%20%10th90th$1,349$1.0K$2.0K$5.0K$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
$660.69 / $4,365.16 / $17,782.79
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,548.82 / $2,344.23
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,819.70 / $2,041.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,348.96 / $1,479.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $19,498.45