go back

New Mexico rates for HCPCS 52317

Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$973.32 / $2,145.78 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.64 / $910.82 / $1,467.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,580.54 / $8,615.39 / $13,813.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$414.94 / $728.00 / $1,454.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409.94 / $656.09 / $1,547.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $731.72 / $1,259.48
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$339.81 / $446.20 / $1,790.67
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409.94 / $656.09 / $1,547.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,834.00 / $6,599.00 / $7,158.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.29 / $1,448.26 / $2,022.57