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New Mexico rates for HCPCS Q4176

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$180.50 / $180.50 / $180.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.00 / $157.69 / $180.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.50 / $161.50 / $161.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.50 / $161.50 / $161.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.72 / $60.00 / $107.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.92 / $153.90 / $162.60
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.50 / $161.50 / $203.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.51 / $167.51 / $167.51