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Michigan 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
$39.70 / $39.70 / $39.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $39.70 / $39.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,248.33 / $1,920.88 / $3,845.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.46 / $17.30 / $22.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.63 / $38.54 / $57.07
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.54 / $39.70 / $64.48
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $48.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.39 / $54.03 / $68.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $40.89