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Louisiana rates for HCPCS Q4106

Dermagraft, per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.94 / $44.94 / $44.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.96 / $44.94 / $44.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.60 / $30.60 / $45.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.60 / $30.60 / $31.21
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.40 / $50.94 / $62.15