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Pennsylvania rates for HCPCS Q4128

Flex Hd Or Allopatch Hd Per Square Centimeter (Desc Revised 10/01/2022)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.91 / $81.05 / $20,192.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $30.81
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.42 / $29.91 / $44.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $29.91
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 / $29.91
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.63 / $31.04 / $38.21
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.41 / $65.67 / $198.34
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.00 / $81.05 / $61,137.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $36.89
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.22 / $29.91 / $29.91
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $29.91
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.68 / $30.68 / $35.60
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.68 / $30.68 / $35.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.56 / $29.91 / $39.03