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Oklahoma rates for HCPCS Q4106

Dermagraft, per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.40 / $36.40 / $36.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.40 / $36.40 / $36.85
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
$33.00 / $38.22 / $55.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.21 / $50.94 / $1,816.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.95 / $50.94 / $56.17