search again

Nationwide rates for HCPCS Q4105

Integra Dermal Regeneration Template (Drt) Or Or Integra Omnigraft Dermal Regeneration Matrix Per Square Centimeter (Desc Rvsd 1/1/17)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.94 / $26.94 / $27.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.94 / $26.94 / $29.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.94 / $26.94 / $51.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.94 / $26.94 / $27.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.42 / $26.94 / $26.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.94 / $26.94 / $29.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.77 / $39.38 / $43.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.94 / $26.94 / $32.33