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Mississippi 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
$23.53 / $23.53 / $34.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.95 / $24.39 / $34.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.95 / $14.95 / $16.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.00 / $14.00 / $14.00
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.26 / $28.69 / $37.29