go back

Ohio 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
$71.55 / $71.55 / $83.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $73.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $82.28 / $138.91
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.55 / $71.55 / $108.04
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $96.59
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 / $101.25
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.55 / $88.55 / $88.55
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $104.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.36 / $62.04 / $93.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $88.79