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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
$131.83 / $134.90 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $446.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $109.65 / $138.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $144.54 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $131.83 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $144.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $199.53 / $457.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $141.25 / $2,290.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $177.83 / $208.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $134.90 / $371.54