go back

Tennessee 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
$15.14 / $57.54 / $12,589.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $28.84 / $32.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $33.11 / $125.89