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Alaska rates for HCPCS Q4153

Dermavest and Plurivest, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.54 / $256.54 / $256.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.93 / $137.93 / $137.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $137.93 / $195.18
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.60 / $256.54 / $359.16
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $137.93 / $179.31
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$351.26 / $351.26 / $3,495.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.89 / $245.89 / $245.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.93 / $256.54 / $359.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $185.51 / $290.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.90 / $206.90 / $413.79