go back

Mississippi rates for HCPCS Q4122

Dermacell Dermacell Awm Or Dermacell Awm Porous Per Square Centimeter (Desc Rvsd 10/1/19)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.22 / $99.22 / $145.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.80 / $102.85 / $145.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $107.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.32 / $5.32 / $5.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.85 / $102.85 / $102.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.85 / $102.85 / $102.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $25.00 / $50.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.50 / $110.00 / $143.00