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Texas 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 $4,467 · 10th–90th $1,148–$14,7910%5%10th90th$4,467$100.0$500.0$2.0K$10.0K$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
$1,148.15 / $4,168.69 / $12,589.25
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,760.83 / $12,882.50 / $25,118.86
Baylor Scott & White
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $4,897.79 / $8,912.51
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $9,120.11 / $9,120.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,467.37 / $6,918.31
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $28,183.83
Lucent Health
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,995.26 / $7,413.10
Moda Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,659.59 / $2,818.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $6,606.93 / $12,589.25