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Nebraska 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
$38.54 / $49.12 / $49.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $49.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.09 / $43.64 / $43.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.46 / $43.64 / $55.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.54 / $39.97 / $42.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $60.57 / $77.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.36 / $78.59 / $99.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.12 / $49.12 / $97.33
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.12 / $58.94 / $67.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.35 / $58.94 / $85.76
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.40 / $40.40 / $48.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $41.67