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Indiana 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)

Facilitymedian $16,218 · 10th–90th $1,318–$46,7740%5%10%10th90th$16,218$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K

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
$1,258.93 / $10,471.29 / $16,218.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,715.19 / $38,904.51 / $57,543.99
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,122.02 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,041.74 / $2,754.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $9,549.93 / $18,197.01