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New Mexico rates for HCPCS A5114

Leg strap; foam or fabric, replacement only, per set

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.09 / $9.09 / $9.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.50 / $9.09 / $36.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.49 / $9.99 / $11.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.51 / $7.51 / $7.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.38 / $7.51 / $8.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $12.50 / $18.75
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.42 / $3.42 / $9.39
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.38 / $8.58 / $12.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.78 / $5.30 / $7.98