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Nebraska 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
$29.91 / $29.91 / $30.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $32.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.78 / $33.86 / $33.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.17 / $33.85 / $34.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.91 / $29.91 / $54.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.36 / $34.88 / $45.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.70 / $50.66 / $68.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.47 / $30.70 / $30.70
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.36 / $34.88 / $39.77
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.36 / $36.84 / $45.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.41 / $29.91 / $29.91