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New Mexico rates for HCPCS 50400

Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $7,838.38 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,118.61 / $1,239.83 / $1,892.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,024.35 / $1,766.33 / $2,173.64
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $332.35 / $1,793.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,138.85 / $1,449.46 / $1,779.79
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,354.19 / $1,766.33 / $2,173.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,602.00 / $9,127.00 / $10,150.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,469.50 / $1,848.54 / $2,641.76