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New Mexico rates for HCPCS L3390

Outflare Wedge (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.46 / $29.46 / $29.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.46 / $45.24 / $168.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.99 / $47.99 / $57.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.99 / $43.99 / $43.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.11 / $43.99 / $43.99
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.40 / $88.01 / $132.01
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.19 / $17.19 / $45.14
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.11 / $43.99 / $68.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.17 / $26.63 / $40.11