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Wisconsin 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 $15,136 · 10th–90th $5,623–$25,1190%10%10th90th$15,136Professionalmedian $2,512 · 10th–90th $1,288–$4,7860%10%10th90th$2,512$1.0K$2.0K$5.0K$10.0K$20.0K

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
$2,290.87 / $9,332.54 / $17,378.01
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$13,489.63 / $13,489.63 / $13,489.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $16,982.44 / $29,512.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,388.44 / $5,370.32
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $7,244.36 / $13,489.63
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $8,317.64 / $15,848.93
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $9,332.54 / $15,848.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,511.89 / $4,786.30
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,197.01 / $26,915.35 / $26,915.35
Quartz
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $2,691.53
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $6,456.54 / $6,456.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $16,218.10