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New Mexico rates for HCPCS Q4196

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $102.04 / $128.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.45 / $512.21 / $889.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.15 / $116.20 / $116.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.71 / $171.90 / $197.56
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.03 / $101.03 / $111.13
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $131.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.03 / $101.03 / $101.03