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New Mexico rates for HCPCS A4221

Supplies for maintenance of noninsulin drug infusion catheter, per week (list drugs separately)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.35 / $19.35 / $19.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.28 / $15.50 / $19.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.01 / $20.01 / $25.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.09 / $15.09 / $15.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.60 / $32.34 / $41.06
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $24.90 / $24.90
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.09 / $15.09 / $33.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.40 / $13.15 / $20.20