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Indiana 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
$65.39 / $108.04 / $108.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.97 / $106.97 / $108.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.97 / $106.97 / $206.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.97 / $106.97 / $151.88
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.97 / $106.97 / $160.46
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.97 / $106.97 / $123.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.97 / $106.97 / $106.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.97 / $106.97 / $106.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.97 / $106.97 / $132.63