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New Mexico rates for HCPCS A4802

Protamine Sulfate For Hemodialysis Per 50 Mg (Special Coverage Instructions Apply. See Mcm: 4270)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.78 / $13.10 / $15.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.58 / $13.58 / $13.58
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
$3.33 / $12.78 / $15.98
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.92 / $13.58 / $13.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.77 / $2.17 / $3.61