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New Mexico rates for HCPCS Q4153

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.93 / $137.93 / $137.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $139.31 / $175.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.93 / $137.93 / $137.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $137.93 / $137.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $116.26 / $208.77
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.93 / $137.93 / $154.58
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $137.93 / $193.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $137.93 / $137.93