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Connecticut 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
Professional
Modifier
Low / Median / High Price
$81.00 / $81.00 / $81.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.31 / $41.07 / $52.21
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.00 / $25.00 / $25.00