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Iowa 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
$7.12 / $10.75 / $10.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.87 / $7.87 / $24.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.87 / $11.87 / $12.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.46 / $9.11 / $10.21
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.69 / $7.87 / $14.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.12 / $9.52 / $15.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.12 / $7.12 / $14.24
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.35 / $9.11 / $10.99
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.42 / $9.11 / $10.99
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.30 / $12.90 / $15.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.87 / $7.87 / $8.66
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.12 / $7.12 / $7.12
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.62 / $7.12 / $7.12