go back

Virginia rates for HCPCS Q4106

Dermagraft, per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.20 / $38.20 / $38.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.96 / $38.20 / $38.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.94 / $44.94 / $59.98
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.78 / $40.78 / $40.78
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.37 / $36.47 / $53.05
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.20 / $44.94 / $60.74
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.81 / $50.00 / $107.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.94 / $50.94 / $53.49