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New Mexico rates for HCPCS Q4111

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

Facilitymedian $9 · 10th–90th $7–$1350%20%10th90th$9Professionalmedian $7 · 10th–90th $7–$1170%50%90th$7$10.0$20.0$50.0$100.0$200.0

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
$7.08 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $8.91
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
$7.41 / $10.00 / $33.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $9.12 / $134.90
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $7.59 / $9.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $125.89 / $125.89