go back

New Mexico rates for HCPCS L4030

Replace quadrilateral socket brim, custom fitted

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.80 / $363.80 / $363.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.62 / $558.69 / $2,188.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$477.88 / $477.88 / $477.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.85 / $348.85 / $907.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.52 / $741.91 / $1,112.86
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$183.20 / $183.20 / $557.55
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.85 / $477.88 / $872.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.66 / $283.76 / $427.46