New Mexico · 96417

Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in New Mexico

New Mexico Medicare Avg
$47.59
6% below national avg
National Medicare Avg
$50.77
All states combined
Billed Charge (NM)
$251.23
What providers submit
Est. Commercial (NM)
$128.12
National avg: $137.32
Est. Cash / Self-Pay (NM)
$113.78
Typical self-pay discount

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

2.1K
Services in NM
44
Providers
N/A
Min Payment
N/A
Max Payment

New Mexico Pricing in Context

In New Mexico, CPT code 96417 (Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less) carries an average Medicare payment of $47.59 — 6% below the national benchmark of $50.77. 44 providers across the state submitted claims for this procedure in 2023, performing 2.1K 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 $251.23, 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 Medicine procedures, the estimated commercial insurance price in New Mexico lands near $128.12, with self-pay cash prices typically around $113.78. 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 Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cost in New Mexico?

The average Medicare payment for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in New Mexico is $47.59, which is 6% below the national average of $50.77. Providers in NM typically bill $251.23 for this procedure.

What does Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cost with insurance in New Mexico?

With commercial insurance in New Mexico, Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs an estimated $128.12. Without insurance, the estimated cash price is $113.78. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in New Mexico?

44 providers in New Mexico billed Medicare for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in 2023, performing 2.1K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cheaper in New Mexico than the national average?

Yes — Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs 6% below the national average in New Mexico. The state average Medicare payment is $47.59 compared to $50.77 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