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Missouri rates for HCPCS Q4153

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.93 / $142.06 / $142.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $140.69 / $165.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.60 / $154.84 / $208.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.12 / $130.12 / $137.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $137.93 / $175.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.77 / $161.59 / $270.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.60 / $108.60 / $1,027.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $137.93 / $168.69