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Maryland rates for HCPCS Q4154

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.86 / $142.86 / $142.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $131.90 / $153.00
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.61 / $298.61 / $298.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.90 / $131.90 / $382.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $131.90 / $167.98
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.12 / $131.90 / $407.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $131.90 / $139.81
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.36 / $144.36 / $172.79