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New Mexico rates for HCPCS L3214

Benesch Boot Pair Junior (Special Coverage Instructions Apply. See Mcm: 2079)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.13 / $28.13 / $28.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.18 / $40.53 / $40.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.68 / $49.68 / $49.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.27 / $49.68 / $61.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.22 / $25.22 / $73.51
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.27 / $49.68 / $49.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.91 / $32.92 / $56.62