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Virginia 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 $5,370 · 10th–90th $977–$15,8490%5%10th90th$5,370Professionalmedian $813 · 10th–90th $617–$1,9050%10%10th90th$813$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $5,495.41 / $15,488.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,748.98 / $14,791.08 / $15,848.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $724.44 / $1,905.46
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,412.54 / $1,995.26
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,202.26 / $1,819.70
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,174.90 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $10,471.29 / $21,379.62