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Missouri 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
$135.86 / $450.00 / $472.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $134.54 / $184.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.82 / $131.90 / $174.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.43 / $124.43 / $131.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $131.90 / $167.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$145.71 / $209.68 / $450.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.66 / $142.86 / $2,287.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $131.90 / $161.31