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North Carolina 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
$303.88 / $6,484.54 / $43,459.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $31.21 / $31.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.80 / $21.35 / $22.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.22 / $29.91 / $29.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $29.91
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.68 / $31.21 / $46.02
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.68 / $30.68 / $38.74
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.20 / $43.20 / $43.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $38.88
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $85.00 / $135.06
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.06 / $135.06 / $135.06