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New Mexico rates for HCPCS J1726

Injection, hydroxyprogesterone caproate, (Makena), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $45.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.05 / $19.95 / $23.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.75 / $2.75 / $2.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.42 / $20.42 / $20.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.50 / $19.50