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New Mexico rates for HCPCS J1457

Injection Gallium Nitrate 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.26 / $1.26 / $1.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.26 / $1.52 / $1.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.08 / $2.08 / $2.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.08 / $2.08 / $2.08
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.87 / $2.08
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.08 / $2.08 / $2.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.40 / $2.40 / $2.40