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Kansas 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
$91.20 / $91.20 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $79.43 / $93.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $77.62 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $77.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.11 / $104.71 / $245.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $85.11 / $380.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $83.18 / $83.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $83.18 / $125.89