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Nebraska rates for HCPCS A6504

Compression Burn Garment Glove To Wrist Custom Fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.80 / $506.25 / $632.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $144.00 / $171.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.66 / $143.65 / $143.65
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.66 / $69.66 / $69.66
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.75 / $60.75 / $69.66