go back

Kentucky rates for HCPCS Q4106

Dermagraft, per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.96 / $35.96 / $35.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.96 / $35.96 / $37.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.88 / $53.00 / $53.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.39 / $44.94 / $44.94
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.40 / $34.15 / $40.29
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.40 / $26.84 / $37.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.94 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.94 / $44.94 / $63.60
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.29 / $44.94 / $58.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.94 / $50.94 / $54.56