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New Mexico rates for HCPCS Q4188

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $239.88 / $524.81
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $489.78 / $1,071.52
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $436.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $489.78 / $977.24