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Nebraska rates for HCPCS Q4106

Dermagraft, per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.96 / $35.96 / $44.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.96 / $35.96 / $38.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.25 / $50.88 / $50.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.34 / $50.88 / $50.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.94 / $69.55 / $83.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.28 / $51.75 / $115.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.96 / $61.13 / $100.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.94 / $50.94 / $76.41
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.69 / $51.75 / $69.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.29 / $47.78 / $83.15
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.09 / $71.90 / $82.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.39 / $50.94 / $50.94