go back

Nebraska rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$718.00 / $718.00 / $897.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.00 / $718.00 / $762.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$884.87 / $1,041.02 / $1,041.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$988.97 / $1,041.02 / $1,041.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$670.85 / $735.08 / $762.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.88 / $1,053.06 / $1,210.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.66 / $897.50 / $1,364.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,997.50 / $1,997.50 / $2,057.42
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.06 / $1,053.06 / $1,240.79
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.83 / $1,046.49 / $1,240.79
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$631.40 / $631.40 / $765.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,897.63 / $1,997.50 / $1,997.50