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New Mexico rates for HCPCS 21089

Unlisted maxillofacial prosthetic procedure

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $426.58 / $691.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $60.26 / $85.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $1,096.48 / $1,412.54