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Iowa rates for HCPCS Q4113

Graftjacket Xpress

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$897.50 / $897.50 / $897.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.00 / $744.93 / $897.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$581.44 / $581.44 / $624.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$677.79 / $1,033.13 / $1,188.99
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.00 / $827.41 / $1,014.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.32 / $897.50 / $1,220.59
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,837.70 / $1,997.50 / $3,410.50
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$284.83 / $479.00 / $1,240.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.06 / $499.78 / $1,240.79
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.29 / $694.50 / $765.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,997.50 / $1,997.50 / $3,478.45
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$990.00 / $990.00 / $990.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$782.10 / $990.00 / $990.00