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New Mexico rates for HCPCS J0287

Injection, amphotericin B lipid complex, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $23.99 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.00 / $12.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $10.72 / $10.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.72 / $10.72 / $10.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $11.75 / $11.75
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.55 / $11.48 / $21.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.72 / $10.72 / $10.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $10.72 / $10.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.23 / $10.47 / $10.47