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New Mexico rates for HCPCS Q4253

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

Facilitymedian $95 · 10th–90th $76–$6760%20%10th90th$95Professionalmedian $76 · 10th–90th $76–$1260%50%90th$76$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $93.33
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $89.13 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $120.23 / $467.74
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $1,148.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $125.89