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Kentucky 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
$38.02 / $38.02 / $38.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $47.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $38.90 / $48.98
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $38.90 / $61.66
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $41.69 / $53.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $85.11 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $38.90 / $162.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $39.81 / $53.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $97.72 / $125.89