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New Mexico rates for HCPCS A6504

Compression burn garment, glove to wrist, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$994.40 / $1,203.25 / $81,099.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.80 / $90.80 / $90.80
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $191.60 / $1,500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.80 / $90.80 / $90.80