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Pennsylvania rates for HCPCS 51050

Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$882.00 / $4,264.00 / $8,240.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,161.29 / $10,161.29 / $10,161.29
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.00 / $4,761.00 / $8,247.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.60 / $458.60 / $557.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00