go back

Wyoming 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 / $71.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $77.98 / $78.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.55 / $104.18 / $104.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.50 / $67.50 / $67.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $101.25 / $101.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $71.55