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Pennsylvania 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 $7,244 · 10th–90th $1,479–$22,3870%5%10th90th$7,244$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
$1,479.11 / $7,244.36 / $21,877.62
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $10,000.00 / $57,543.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,918.31 / $24,547.09 / $57,543.99
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$41,686.94 / $41,686.94 / $41,686.94
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $4,570.88 / $19,498.45
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,348.96 / $1,479.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $5,754.40 / $30,199.52