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Pennsylvania rates for HCPCS 52317

Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm)

Facilitymedian $2,512 · 10th–90th $537–$9,1200%5%10%10th90th$2,512Professionalmedian $794 · 10th–90th $331–$1,8200%10%20%10th90th$794$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$537.03 / $2,570.40 / $9,120.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $794.33 / $1,819.70
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,137.96 / $30,902.95
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $7,585.78 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,047.13 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $645.65 / $1,513.56
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,479.11
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $1,174.90 / $1,819.70
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $8,128.31 / $14,125.38
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,737.80 / $8,912.51
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $1,584.89 / $8,511.38
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $794.33 / $1,778.28
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,348.96 / $1,819.70
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $331.13 / $1,288.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $338.84 / $870.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,981.07 / $11,220.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $707.95 / $1,513.56