go back

Arkansas rates for HCPCS Q4111

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.44 / $9.44 / $9.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.87 / $8.27 / $9.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.72 / $7.72 / $7.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.72 / $7.72 / $7.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.43 / $7.87 / $10.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.87 / $7.87 / $8.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.87 / $8.11