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New Mexico rates for HCPCS V2104

Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.21 / $42.53 / $45.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.40 / $30.96 / $41.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.70 / $21.70 / $21.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.02 / $60.00 / $84.22
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.58 / $38.81 / $45.24
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.70 / $21.70 / $46.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.85 / $22.55 / $33.97