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New York 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
$28.84 / $151.36 / $18,620.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $28.84 / $39.81
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $28.18 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $32.36
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $138.04 / $338.84
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $30.90 / $257.04
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.90
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.90 / $30.90
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $67.61 / $8,317.64
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $33.11 / $33.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $114.82 / $125.89
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $33.11
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.90 / $30.90