go back

Oklahoma 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
$40.74 / $40.74 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $38.02 / $45.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $36.31 / $38.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.90 / $38.90 / $38.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $56.23 / $83.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $48.98 / $70.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $50.12 / $50.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $61.66 / $125.89