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Tennessee rates for HCPCS Q4106

Dermagraft, per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.29 / $37.29 / $65.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.96 / $37.29 / $38.20
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
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.26 / $152.21 / $157.75
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,816.40 / $1,816.40 / $1,816.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.39 / $50.94 / $50.94