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Kansas 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
$41.69 / $9,332.54 / $23,988.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $25.70 / $30.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $33.11 / $44.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $30.90 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $30.90 / $30.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.12 / $30.90 / $89.13
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $30.90 / $30.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $26.30 / $30.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $30.90 / $125.89