go back

New Mexico rates for HCPCS 50750

Ureterocalycostomy, anastomosis of ureter to renal calyx

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
$1,115.66 / $1,241.51 / $1,888.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,021.97 / $1,766.35 / $2,168.27
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $331.65 / $1,789.74
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,161.08 / $1,477.74 / $1,783.34
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,354.20 / $1,766.35 / $2,168.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,085.00 / $4,262.00 / $17,636.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,498.50 / $1,898.10 / $2,628.34