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Georgia rates for HCPCS Q4123

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.19 / $71.55 / $71.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $78.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $72.98
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.55 / $71.55 / $140.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.50 / $67.50 / $71.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $91.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.55 / $88.55 / $116.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.64 / $132.37 / $239.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $92.47