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Utah 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 $3,388 · 10th–90th $1,230–$6,9180%10%10th90th$3,388Professionalmedian $871 · 10th–90th $347–$1,9500%10%10th90th$871$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
$1,230.27 / $3,388.44 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $870.96 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $724.44 / $1,513.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $2,089.30
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
$489.78 / $1,148.15 / $1,737.80
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $933.25 / $2,238.72
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $1,148.15 / $2,041.74
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
$354.81 / $776.25 / $1,479.11