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New Mexico rates for HCPCS 40804

Removal of embedded foreign body, vestibule of mouth; simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $309.03 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $190.55 / $501.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $707.95 / $1,174.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $199.53 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $229.09 / $363.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $263.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $245.47 / $446.68
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $229.09 / $363.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $3,981.07 / $5,011.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $223.87 / $371.54