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Florida 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
$10.96 / $11.75 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $11.75 / $13.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.22 / $11.75 / $11.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $11.75 / $11.75
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $30.90 / $30.90
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $85.11 / $131.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.41 / $10.23 / $32.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.02 / $14.79 / $21.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $30.20 / $125.89
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.08 / $134.90