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Mississippi 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
$145.68 / $145.68 / $166.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $145.68 / $166.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.81 / $125.81 / $138.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.85 / $158.85 / $158.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.74 / $138.74 / $138.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $138.74 / $138.74
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.80 / $138.74 / $180.36