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Texas rates for HCPCS Q4113

Graftjacket Xpress

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$718.00 / $735.95 / $735.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.00 / $735.95 / $762.88
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.88 / $762.88 / $762.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.88 / $762.88 / $762.88
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$897.50 / $1,795.00 / $3,365.63
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,410.50 / $3,410.50 / $4,038.75
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$344.82 / $919.55 / $1,655.89
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$631.40 / $663.00 / $765.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$344.82 / $919.55 / $1,375.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.88 / $762.88 / $762.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,997.50 / $1,997.50 / $1,997.50
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.00 / $718.00 / $969.30