go back

Texas rates for HCPCS Q4100

Skin Substitute, Nos

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,315.27 / $5,286.19 / $13,055.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.74 / $34.65 / $147.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,456.92 / $5,821.21 / $8,577.84
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,316.09 / $3,546.62 / $3,964.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.00 / $64.00 / $64.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.40 / $125.40 / $125.40
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.74 / $4,323.68 / $19,769.43
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.74 / $34.65 / $147.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.40 / $125.40 / $125.40
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.00 / $750.00 / $750.00