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New Mexico rates for HCPCS Q4137

AmnioExcel, AmnioExcel Plus or BioDExcel, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.72 / $101.72 / $101.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.72 / $102.73 / $129.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.72 / $101.72 / $101.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.72 / $101.72 / $101.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.88 / $119.88 / $179.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$94.99 / $101.72 / $111.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.72 / $101.72 / $134.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.72 / $101.72 / $101.72