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Arkansas rates for HCPCS Q4102

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $14.13 / $14.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $11.75 / $14.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $12.88 / $12.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $12.88 / $12.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $11.75 / $11.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $11.75 / $13.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $33.88 / $125.89