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New Mexico rates for HCPCS Q4139

AmnioMatrix or BioDMatrix, injectable, 1 cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$640.00 / $640.00 / $640.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$640.00 / $640.00 / $1,820.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $1,500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$640.00 / $987.52 / $1,820.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,400,000.00 / $2,400,000.00 / $2,400,000.00