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Indiana rates for HCPCS Q4108

Integra matrix, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.93 / $38.93 / $49.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $42.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.54 / $38.54 / $74.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $54.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.54 / $38.54 / $59.74
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $46.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.54 / $38.54 / $38.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $63.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $51.26