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New Mexico rates for HCPCS Q4124

OASIS ultra tri-layer wound matrix, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $46 · 10th–90th $3–$1260%10%10th90th$46Professionalmedian $2 · 10th–90th $2–$1170%50%90th$2$2.0$20.0$200.0$2.0K$20.0K

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
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $3.02
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $56.23 / $91.20
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
$7.08 / $10.47 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.51 / $4.17 / $134.90
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.12 / $9.12 / $16.22
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $125.89 / $125.89