go back

Kansas rates for HCPCS Q4115

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.01 / $18.01 / $18.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.86 / $13.12 / $18.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.13 / $12.86 / $13.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.86 / $12.86 / $12.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.41 / $14.76 / $23.31
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.48 / $14.48 / $66.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.86 / $12.86 / $14.48