go back

New Mexico rates for HCPCS Q4121

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.75 / $52.75 / $52.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.75 / $53.28 / $67.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.16 / $220.10 / $382.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.75 / $52.75 / $52.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.75 / $52.75 / $52.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.87 / $51.79 / $84.42
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.74 / $52.75 / $66.44
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.75 / $52.75 / $61.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.75 / $52.75 / $52.75