go back

Florida rates for HCPCS Q4124

OASIS ultra tri-layer wound matrix, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.48 / $2.49 / $2.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.49 / $2.49 / $2.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.35 / $2.49 / $2.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.49 / $2.49 / $2.49
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.49 / $2.49 / $2.49
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $2.49 / $2.49
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $156.41 / $221.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.49 / $2.49 / $2.50
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.48 / $2.48 / $2.49