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New Mexico rates for HCPCS 42280

Maxillary Impresj Palatal Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.79 / $2,145.78 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.66 / $157.40 / $250.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.27 / $135.27 / $183.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.58 / $190.34 / $303.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $49.12 / $262.70
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.42 / $161.16 / $215.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.94 / $221.51 / $380.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.00 / $1,158.00 / $1,327.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.54 / $248.93 / $370.85