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Washington 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 $11,220 · 10th–90th $1,950–$33,1130%5%10th90th$11,220$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K$100.0K

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
$2,089.30 / $13,803.84 / $26,302.68
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,782.79 / $24,547.09 / $50,118.72
Asuris Northwest Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$26,302.68 / $37,153.52 / $74,131.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,754.23 / $25,703.96
Kaiser Permanente
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$11,748.98 / $37,153.52 / $67,608.30
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,187.76 / $2,511.89
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,698.24 / $1,698.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $25,703.96 / $50,118.72
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$25,118.86 / $38,018.94 / $74,131.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $29,512.09 / $53,703.18