go back

North Dakota 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
$1,288.25 / $9,549.93 / $11,481.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $2,187.76 / $10,471.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,943.28 / $8,912.51 / $8,912.51