go back

California rates for HCPCS Q4125

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.91 / $138.91 / $138.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.91 / $138.91 / $138.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.17 / $40.21 / $41.29
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.70 / $1.00 / $2.47
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.00 / $638.07 / $801.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $85.00 / $85.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.91 / $138.91 / $311.18
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $2,250,000.00 / $2,400,000.00