go back

Arizona rates for HCPCS Q4141

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.66 / $117.66 / $117.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.97 / $108.04 / $117.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.54 / $72.16 / $178.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.02 / $38.18 / $90.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.91 / $106.97 / $106.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.97 / $106.97 / $106.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.08 / $78.34 / $155.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.75 / $64.75 / $140.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.97 / $106.97 / $106.97