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Arizona rates for HCPCS Q4132

Grafix Core and GrafixPL Core, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $186.21 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $107.15 / $173.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $53.70 / $131.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $54.95 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $107.15 / $107.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $107.15 / $478.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $89.13 / $154.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $61.66 / $562.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $125.89 / $467.74