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Ohio rates for HCPCS Q4004

Cast supplies, shoulder cast, adult (11 years +), fiberglass

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $95.50 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $100.00 / $134.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $81.28 / $177.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $173.78 / $199.53
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $199.53 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $50.12 / $79.43
SummaCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $181.97 / $363.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $70.79 / $93.33