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Indiana rates for HCPCS Q4128

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.21 / $31.00 / $57,018.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $31.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.91 / $29.91 / $57.73
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $42.47
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.91 / $29.91 / $44.87
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $35.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.91 / $29.91 / $29.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $30.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $39.95