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New Mexico rates for HCPCS 21172

Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $7,838.38 / $8,644.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,652.75 / $2,090.25 / $4,494.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,599.62 / $2,636.40 / $3,755.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,755.42 / $2,720.89 / $3,887.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $3,149.64
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,745.05 / $2,383.92 / $3,347.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,903.67 / $2,808.66 / $5,238.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,315.00 / $11,259.00 / $12,494.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,975.85 / $2,887.38 / $4,240.78