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Maine rates for HCPCS Q4106

Dermagraft, per sq cm

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.85 / $38.20 / $38.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.94 / $44.94 / $44.94
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
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.20 / $38.20 / $38.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.94 / $50.94 / $73.86