go back

New York 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 / $151.36 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $93.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $81.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $74.13 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $77.62 / $89.13
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $144.54 / $338.84
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $81.28 / $316.23
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $77.62 / $81.28
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $81.28 / $81.28
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $91.20 / $91.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $123.03 / $134.90
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $77.62 / $87.10
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $81.28 / $81.28