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New Mexico rates for HCPCS A4257

Replacement lens shield cartridge for use with laser skin piercing device, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.96 / $12.96 / $12.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.23 / $11.71 / $12.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $8.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.48 / $17.82 / $29.06
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.84 / $14.03 / $15.39
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $7.28 / $25.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.99 / $7.56 / $11.38