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Utah rates for HCPCS 51065

Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus

Facilitymedian $6,026 · 10th–90th $3,162–$9,1200%10%10th90th$6,026Professionalmedian $741 · 10th–90th $550–$1,3180%10%10th90th$741$50.0$200.0$1.0K$5.0K

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 / $6,025.60 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $630.96 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $794.33 / $1,096.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,023.29
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $6,760.83 / $10,232.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,000.00 / $1,288.25
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,071.52 / $1,202.26
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $891.25 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $5,128.61 / $7,244.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $691.83 / $1,202.26