Anesthesia for kidney stone destruction

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR ANESTH KIDNEY STONE DESTR W H20 BATH

Payers reporting CPT 00872

Payer pricing summary

Low

Average

$1.7k

Median

$301

High

$12.7k

Payer rate distribution

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#
1	Molina facility · case rate · outpatient · +10 other terms	29	$127	$106	$96	91%	—	$15 – $308
2	UnitedHealthcare professional · case rate · outpatient · +20 other terms	20	$21	$21	—	—	—	$21 – $21
3	Humana professional · case rate · outpatient · +14 other terms	19	$21	$21	—	—	—	$21 – $21
4	Aetna fee schedule · outpatient · +18 other terms	18	$38	$1.5k	$2.5k	170%	—	$29 – $8.4k
5	Regence professional · case rate · outpatient · +2 other terms	17	$21	$21	—	—	—	$21 – $21
6	Anthem facility · case rate · outpatient · +14 other terms	15	$182	$199	$47	23%	—	$124 – $308
7	Caresource facility · case rate · outpatient · +4 other terms	15	$185	$199	$46	23%	—	$124 – $314
8	Blue Cross Blue Shield fee schedule · outpatient · +12 other terms	14	$76	$112	$127	113%	—	$0 – $607
9	Optum facility · case rate · outpatient · +2 other terms	13	$164	$161	$74	46%	—	$14 – $279
10	Cigna professional · other · outpatient · +15 other terms	11	$79	$79	$28	35%	—	$21 – $130
11	Medicaid fee schedule · outpatient · +2 other terms	10	$607	$607	—	—	—	$607 – $607
12	WellCare professional · fee schedule · both · +6 other terms	9	$14	$15	$10	63%	—	$0 – $42
13	Aetna Better Health professional · fee schedule · both · +2 other terms	8	$10	$11	$9	81%	—	$0 – $21
14	Amerihealth Caritas facility · case rate · outpatient · +5 other terms	7	$16	$16	$1	3%	—	$16 – $18
15	Bcbs Il professional · fee schedule · both · +2 other terms	7	$10	$8	$10	120%	—	$0 – $21
16	Ambetter other · outpatient · +6 other terms	6	$4.0k	$4.0k	—	—	—	$4.0k – $4.0k
17	Highmark other · outpatient · +4 other terms	6	$4.0k	$4.0k	—	—	—	$4.0k – $4.0k
18	Tricare other · outpatient · +3 other terms	6	$4.0k	$4.0k	—	—	—	$4.0k – $4.0k
19	Bcbs Mn fee schedule · outpatient	5	$1	$1	$0	66%	—	$0 – $1
20	First Health professional · fee schedule · both · +4 other terms	5	$64	$64	—	—	—	$64 – $64
21	Kaiser fee schedule · outpatient · +1 other terms	4	$607	$275	$287	104%	—	$26 – $607
22	MultiPlan professional · fee schedule · both · +10 other terms	4	$64	$61	$6	10%	—	$50 – $66
23	Oscar fee schedule · both · +3 other terms	4	$40	$40	—	—	—	$40 – $40
24	Phcs fee schedule · both · +3 other terms	4	$156	$156	—	—	—	$156 – $156
25	Wellmark facility · case rate · outpatient · +1 other terms	3	$53	$46	$15	32%	—	$21 – $58

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