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Colorado rates for HCPCS Q4142

XCM biologic tissue matrix, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.00 / $81.00 / $81.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.00 / $81.00 / $81.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.31 / $41.06 / $41.07
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.00 / $81.00 / $136.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.00 / $155.00 / $329.00