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Wisconsin 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 $6,761 · 10th–90th $955–$11,4820%10%20%10th90th$6,761Professionalmedian $912 · 10th–90th $347–$2,6920%10%10th90th$912$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$398.11 / $954.99 / $2,951.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $851.14 / $1,698.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $7,943.28 / $12,589.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $1,318.26 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,754.23 / $4,466.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $1,174.90 / $3,235.94
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $1,698.24 / $3,801.89
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,148.15 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $3,388.44 / $8,709.64
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,698.24 / $4,786.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $1,023.29
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $5,754.40 / $7,762.47
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,548.82 / $2,951.21
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $1,318.26 / $3,019.95
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $9,332.54 / $9,332.54
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $2,630.27 / $7,585.78
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $4,786.30
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,630.27 / $5,248.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $7,585.78 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $1,148.15 / $3,162.28