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New Mexico rates for HCPCS L8604

Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies

Facilitymedian $4,677 · 10th–90th $2,399–$56,2340%20%40%10th90th$4,677Professionalmedian $2,399 · 10th–90th $95–$2,3990%50%10th$2,399$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $4,677.35 / $4,677.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $2,398.83 / $2,398.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $69,183.10 / $81,283.05
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $60.26 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $2,398.83 / $2,818.38
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $2,398.83