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New Mexico rates for HCPCS Q2009

Injection, fosphenytoin, 50 mg phenytoin equivalent

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.08 / $4.08 / $4.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.56 / $2.72 / $4.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.62 / $2.62 / $2.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.62 / $2.62 / $2.62
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.37 / $2.62 / $7.07
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.62 / $2.62 / $2.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.68 / $7.68 / $7.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.57 / $2.57 / $2.57