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Arkansas rates for HCPCS Q4116

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.44 / $26.44 / $8,976.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.89 / $25.82 / $26.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.28 / $32.28 / $32.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.11 / $31.11 / $47.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.11 / $31.11 / $32.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.00 / $31.11 / $32.04