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New Mexico rates for HCPCS Q4101

Apligraf, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $107 · 10th–90th $30–$2570%10%10th90th$107Professionalmedian $30 · 10th–90th $30–$1260%50%90th$30$20.0$100.0$500.0$2.0K$10.0K$50.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $37.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $165.96 / $263.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $35.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $34.67 / $66.07
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $38.02 / $125.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $53.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $125.89 / $125.89