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Washington 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 $8,128 · 10th–90th $1,288–$30,2000%5%10th90th$8,128$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K$100.0K

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
$1,318.26 / $9,332.54 / $28,840.32
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,782.79 / $24,547.09 / $50,118.72
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,778.28 / $25,703.96
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,348.96 / $1,698.24
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,148.15 / $1,148.15
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $25,703.96 / $50,118.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $29,512.09 / $53,703.18