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Nebraska rates for HCPCS Q4133

Grafix Prime Grafixpl Prime Stravix And Stravixpl Per Square Centimeter (Desc Rvsd 1/1/19)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.18 / $138.74 / $3,304.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $138.74 / $152.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.51 / $157.07 / $157.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.46 / $154.16 / $157.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.74 / $210.72 / $221.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $163.63 / $210.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.18 / $224.70 / $305.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.18 / $136.18 / $282.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.18 / $163.63 / $208.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.97 / $163.63 / $291.64
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.60 / $301.60 / $301.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.80 / $138.74 / $208.11