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New Mexico rates for HCPCS L5974

All lower extremity prostheses, foot, single axis ankle/foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.51 / $175.51 / $175.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.98 / $239.59 / $1,075.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.61 / $254.15 / $302.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.77 / $174.77 / $174.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.58 / $174.77 / $174.77
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.52 / $318.16 / $477.24
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.08 / $90.08 / $239.09
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.58 / $174.77 / $390.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.01 / $186.05 / $215.02