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Kansas rates for HCPCS Q4101

Apligraf, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.41 / $631.41 / $5,925.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.53 / $32.65 / $54.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.71 / $29.16 / $38.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.46 / $31.46 / $31.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.52 / $30.23 / $50.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.23 / $30.23 / $30.23
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.91 / $43.69 / $54.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.30 / $30.30 / $2,212.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.23 / $30.23 / $43.83