go back

New Mexico rates for HCPCS 49904

Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $7,838.38 / $7,838.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,577.78 / $1,577.78 / $1,577.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,325.24 / $1,677.69 / $2,150.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$755.00 / $4,616.00 / $17,636.00