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Iowa 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
$564.00 / $564.00 / $564.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.70 / $106.70 / $564.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.21 / $47.77 / $448.36
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.70 / $106.70 / $472.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.18 / $217.62 / $589.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.18 / $89.18 / $448.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.00 / $156.01 / $217.62
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $164.24 / $304.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.70 / $106.70 / $138.82
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.18 / $89.18 / $89.18
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.45 / $89.18 / $89.18