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Arkansas rates for HCPCS Q4117

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.39 / $24.39 / $24.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.95 / $23.81 / $24.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.35 / $18.35 / $18.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.55 / $18.35 / $18.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.94 / $24.39 / $24.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.39 / $24.39 / $24.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.82 / $28.69 / $29.26