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New Mexico rates for HCPCS L5855

Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $229.09 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $229.09 / $398.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $331.13 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $239.88 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $173.78 / $549.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $416.87 / $616.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $309.03 / $501.19
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $173.78 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $281.84 / $501.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $213.80 / $275.42