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Wyoming 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
$30.30 / $30.30 / $30.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.23 / $32.95 / $33.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.25 / $54.41 / $54.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.52 / $28.52 / $28.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.23 / $42.78 / $42.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.23 / $30.23 / $30.23