go back

Georgia 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
$20.13 / $23.69 / $36.42
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.34 / $98.34 / $100.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.97 / $192.97 / $239.19