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New Mexico rates for HCPCS 90954

End-stage renal disease (ESRD) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional per month

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $1,548.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $954.99 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,174.90 / $1,737.80
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,445.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $1,096.48 / $1,862.09
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,230.27 / $2,187.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,174.90 / $1,621.81