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New Mexico rates for HCPCS 40804

Rmvl Embedded Fb Vestibule Mouth Smpl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.22 / $7,838.38 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.12 / $188.86 / $308.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.12 / $659.49 / $1,145.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.84 / $168.07 / $271.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.77 / $240.22 / $390.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $134.12 / $292.08
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.86 / $149.24 / $276.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.77 / $240.22 / $390.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,085.00 / $3,085.00 / $4,616.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.56 / $309.64 / $456.02