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New Mexico rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Facilitymedian $891 · 10th–90th $372–$1,9950%20%10th90th$891Professionalmedian $741 · 10th–90th $724–$1,3490%50%10th90th$741$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$851.14 / $851.14 / $851.14
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $741.31 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,513.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $1,000.00 / $2,089.30
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $870.96 / $1,318.26
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,454.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26