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New Mexico rates for HCPCS L5695

Addition to lower extremity, above knee (AK), pelvic control, sleeve suspension, neoprene or equal, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.97 / $143.97 / $143.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.56 / $196.53 / $752.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.36 / $208.48 / $248.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.31 / $122.31 / $122.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.29 / $122.31 / $122.31
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.78 / $260.98 / $391.47
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.04 / $63.04 / $196.13
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.29 / $122.31 / $229.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.29 / $111.78 / $149.43