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Utah 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 $6,166 · 10th–90th $3,162–$10,2330%10%10th90th$6,166Professionalmedian $1,072 · 10th–90th $617–$2,5700%10%10th90th$1,072$500.0$1.0K$2.0K$5.0K$10.0K$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
$3,162.28 / $6,025.60 / $7,943.28
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,182.57 / $18,197.01 / $27,542.29
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,071.52 / $2,570.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $19,498.45