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Missouri 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
$37.33 / $9,786.48 / $24,002.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.89 / $24.89 / $32.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.81 / $31.69 / $39.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.11 / $31.11 / $31.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.11 / $31.11 / $39.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.89 / $31.11 / $67.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.49 / $31.11 / $38.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.49 / $31.11 / $35.78