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New Mexico rates for HCPCS 50081

Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; complex (eg, stone[s] > 2 cm, branching stones, stones in multiple locations, ureter stones, complicated anatomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $2,818.38 / $7,762.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,943.28 / $17,378.01 / $28,183.83
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,819.70 / $3,311.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $11,220.18 / $41,686.94