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Arizona rates for HCPCS Q4106

Dermagraft, per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.40 / $89.88 / $89.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.96 / $36.40 / $38.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.24 / $85.62 / $211.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.79 / $45.30 / $107.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.94 / $44.94 / $44.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.94 / $44.94 / $44.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.40 / $44.94 / $71.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.94 / $50.94 / $110.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.94 / $50.94 / $50.94