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Alabama rates for HCPCS Q4150

AlloWrap DS or dry, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $77.62 / $77.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $77.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $83.18 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $87.10 / $125.89