search again

Nationwide rates for HCPCS Q4105

Integra dermal regeneration template (DRT) or Integra Omnigraft dermal regeneration matrix, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $26.92 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $25.70 / $36.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.92 / $33.88 / $154.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $64.57 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $26.92 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.92 / $26.92 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $38.02 / $199.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.62 / $83.18 / $125.89