go back

Wisconsin 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 $15,136 · 10th–90th $5,248–$26,3030%10%10th90th$15,136Professionalmedian $1,585 · 10th–90th $813–$2,9510%10%20%10th90th$1,585$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
$707.95 / $16,218.10 / $16,595.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $16,982.44 / $28,840.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,089.30 / $3,311.31
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $7,244.36 / $13,489.63
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $8,317.64 / $15,848.93
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $9,332.54 / $15,848.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,584.89 / $2,951.21
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,197.01 / $26,915.35 / $26,915.35
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $4,466.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $16,218.10