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New Mexico rates for HCPCS 50976

Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $2,145.78 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.80 / $500.01 / $760.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.00 / $717.37 / $880.24
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $133.53 / $720.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$502.04 / $638.96 / $733.71
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.99 / $717.37 / $880.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,085.00 / $3,085.00 / $4,616.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$603.50 / $751.30 / $1,061.76