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Michigan rates for HCPCS Q4140

BioDFence, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.47 / $166.47 / $166.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.62 / $166.47 / $166.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.70 / $75.70 / $75.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.92 / $78.73 / $102.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.62 / $161.62 / $191.06
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.62 / $166.47 / $275.94
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.62 / $161.62 / $193.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $242.43 / $253.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.62 / $161.62 / $174.19