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South Carolina rates for HCPCS Q4101

Apligraf Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.74 / $2,207.62 / $2,207.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.23 / $30.43 / $31.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.97 / $97.36 / $157.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.23 / $48.64 / $62.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.52 / $30.23 / $30.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.23 / $30.23 / $30.23
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.71 / $39.57 / $65.17
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.75 / $34.75 / $34.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.74 / $31.87 / $39.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.81 / $30.23 / $33.25