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Texas 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 $4,365 · 10th–90th $1,000–$15,1360%5%10th90th$4,365$100.0$500.0$2.0K$10.0K$50.0K

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
$1,000.00 / $3,801.89 / $12,882.50
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $12,882.50 / $25,118.86
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $9,772.37 / $9,772.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,467.37 / $6,918.31
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $28,183.83
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,348.96 / $6,760.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $1,122.02 / $1,949.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $6,606.93 / $12,589.25