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New Mexico rates for HCPCS J3095

Injection, telavancin, 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.11 / $11.65 / $11.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $9.02 / $13.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.11 / $7.11 / $7.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.11 / $7.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.63 / $4.63 / $4.63
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.93 / $2.65 / $7.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.11 / $7.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.11 / $7.11 / $7.11