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Ohio 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 $7,943 · 10th–90th $2,455–$12,8820%10%10th90th$7,943$100.0$500.0$2.0K$10.0K

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
$2,691.53 / $7,943.28 / $12,882.50
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $6,606.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $5,888.44 / $30,199.52
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,122.02 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,659.59 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,079.46 / $13,803.84 / $21,379.62
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $11,748.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $7,244.36 / $13,489.63