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Colorado 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
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $58.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $58.88 / $77.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $74.13 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $77.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $190.55 / $213.80
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $134.90 / $134.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $83.18 / $125.89