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New Mexico rates for HCPCS Q4258

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

Facilitymedian $110 · 10th–90th $87–$3240%20%10th90th$110Professionalmedian $89 · 10th–90th $89–$1260%50%90th$89$100.0$200.0$500.0$1.0K

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
$89.13 / $89.13 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $112.20
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
$158.49 / $158.49 / $158.49
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $109.65 / $309.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $125.89 / $125.89