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New Mexico rates for HCPCS B4187

Omegaven, 10 Grams Lipids

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.27 / $14.27 / $14.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.27 / $14.27 / $14.27
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.19 / $95.19 / $95.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.65 / $18.39 / $23.93