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Florida rates for HCPCS 50081

Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; complex (eg, stone[s] > 2 cm, branching stones, stones in multiple locations, ureter stones, complicated anatomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,184.67 / $7,917.00 / $18,125.52
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$14,955.56 / $14,955.56 / $14,955.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,764.24 / $11,061.00 / $26,709.00
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,979.00 / $12,759.00 / $23,031.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,320.00 / $10,309.00 / $15,888.00