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New Mexico rates for HCPCS 50405

Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney, calycoplasty)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $2,041.74 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,737.80 / $5,754.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $2,137.96 / $2,630.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,995.26
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $2,041.74 / $3,630.78
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $2,041.74 / $2,630.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $7,762.47 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,137.96 / $3,162.28