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New Mexico rates for HCPCS A4766

Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.80 / $3.80 / $35.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.70 / $2.70 / $2.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $70.00 / $1,500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.80 / $3.80 / $35.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.70 / $2,250,000.00 / $2,400,000.00