go back

New Mexico rates for HCPCS G0491

Dialysis procedure at a Medicare certified ESRD facility for acute kidney injury without ESRD

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$433.77 / $1,060.57 / $1,060.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,050.00 / $1,050.00 / $1,050.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $60.00 / $500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.77 / $1,060.57 / $1,060.57
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,800,000.00 / $2,250,000.00 / $2,400,000.00