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New Mexico rates for HCPCS 50694

Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $7,838.38 / $8,763.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$342.88 / $342.88 / $1,428.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,602.00 / $9,127.00 / $10,150.00