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Utah rates for HCPCS 50576

Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy

Facilitymedian $3,388 · 10th–90th $2,239–$6,0260%10%20%10th90th$3,388Professionalmedian $708 · 10th–90th $525–$1,2590%20%10th90th$708$50.0$200.0$1.0K$5.0K$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
$812.83 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $602.56 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $794.33 / $1,047.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,258.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,182.57 / $18,197.01 / $27,542.29
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,000.00 / $1,258.93
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $1,023.29 / $1,479.11
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $794.33 / $977.24
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,466.84 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $676.08 / $1,174.90