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Kansas 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
$100.17 / $100.17 / $100.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $72.98 / $100.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.00 / $19.00 / $71.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $71.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.98 / $100.17 / $104.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $395.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $79.78