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New Mexico rates for HCPCS L5000

Partial Foot Shoe Insert With Longitudinal Arch Toe Filler (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.05 / $446.05 / $446.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.22 / $608.90 / $2,081.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,717.42 / $5,516.60 / $10,306.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$484.43 / $645.91 / $769.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.90 / $459.90 / $459.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.73 / $335.73 / $850.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$947.54 / $1,184.43 / $1,776.64
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.32 / $195.32 / $607.65
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.73 / $459.90 / $727.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.73 / $346.33 / $466.21