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Michigan 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
$30.81 / $38.82 / $24,645.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $30.81 / $30.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$477.12 / $734.17 / $1,469.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.66 / $30.01 / $38.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.68 / $29.91 / $31.67
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.91 / $34.39 / $83.63
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $40.67
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $36.70 / $46.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $32.24