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New Mexico rates for HCPCS 0630T

Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; each additional level (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.84 / $2,145.78 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.39 / $76.26 / $116.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $85.00 / $116.24
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.21 / $71.34 / $116.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$230.00 / $1,158.00 / $1,401.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.94 / $118.05 / $179.32