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Kansas rates for HCPCS Q4133

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.63 / $282.63 / $282.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $141.51 / $208.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.05 / $188.39 / $199.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.00 / $187.00 / $187.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.88 / $138.74 / $195.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $138.74 / $138.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.90 / $207.22 / $321.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.18 / $136.18 / $1,448.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $138.74 / $201.17