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Indiana rates for HCPCS Q4100

Skin Substitute, Nos

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,836.48 / $13,836.48 / $49,877.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.74 / $9.74 / $147.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.12 / $14.12 / $27.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.61 / $14.12 / $19.48
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.41 / $64.41 / $83.49
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.41 / $77.29 / $96.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.64 / $125.40 / $125.40