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Utah 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 $7,762 · 10th–90th $3,388–$18,6210%10%10th90th$7,762Professionalmedian $1,698 · 10th–90th $977–$3,2360%20%10th90th$1,698$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
$3,162.28 / $7,413.10 / $13,803.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,182.57 / $18,197.01 / $27,542.29
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$19,952.62 / $26,915.35 / $41,686.94
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,698.24 / $3,235.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $19,498.45