New Mexico · 88302

Pathology Examination Of Tissue Using A Microscope in New Mexico

New Mexico Medicare Avg
$5.39
23% below national avg
National Medicare Avg
$6.98
All states combined
Billed Charge (NM)
$66.47
What providers submit
Est. Commercial (NM)
$14.84
National avg: $20.22
Est. Cash / Self-Pay (NM)
$23.46
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

261
Services in NM
41
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in New Mexico

Provider Medicare Services
Tricore Inc. $5.95 50
Pathology Consultants Of New Mexico $4.85 45

New Mexico Pricing in Context

In New Mexico, CPT code 88302 (Pathology Examination Of Tissue Using A Microscope) carries an average Medicare payment of $5.39 — 23% below the national benchmark of $6.98. 41 providers across the state submitted claims for this procedure in 2023, performing 261 total services. Individual payments in NM ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in New Mexico is $66.47, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because New Mexico sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Pathology procedures, the estimated commercial insurance price in New Mexico lands near $14.84, with self-pay cash prices typically around $23.46. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Pathology Examination Of Tissue Using A Microscope cost in New Mexico?

The average Medicare payment for Pathology Examination Of Tissue Using A Microscope in New Mexico is $5.39, which is 23% below the national average of $6.98. Providers in NM typically bill $66.47 for this procedure.

What does Pathology Examination Of Tissue Using A Microscope cost with insurance in New Mexico?

With commercial insurance in New Mexico, Pathology Examination Of Tissue Using A Microscope costs an estimated $14.84. Without insurance, the estimated cash price is $23.46. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Pathology Examination Of Tissue Using A Microscope in New Mexico?

41 providers in New Mexico billed Medicare for Pathology Examination Of Tissue Using A Microscope in 2023, performing 261 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Pathology Examination Of Tissue Using A Microscope cheaper in New Mexico than the national average?

Yes — Pathology Examination Of Tissue Using A Microscope costs 23% below the national average in New Mexico. The state average Medicare payment is $5.39 compared to $6.98 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial