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Maine rates for HCPCS Q4117

Hyalomatrix Per Sq Cm

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.53 / $24.39 / $24.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.38 / $24.38 / $28.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.39 / $24.39 / $24.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.39 / $24.39 / $24.39
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.91 / $16.91 / $16.91
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.39 / $24.39 / $24.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.39 / $28.69 / $41.60