go back

New Mexico rates for HCPCS C2622

Prosthesis, penile, noninflatable

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $3,768.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $3,768.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $60.00 / $85.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $3,989.95
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,768.95 / $3,768.95 / $2,400,000.00