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Ohio 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
$131.90 / $131.90 / $326.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $131.90 / $135.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $153.00 / $271.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.90 / $131.90 / $224.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $131.90 / $178.07
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 / $186.65
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.50 / $382.50 / $382.50
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $131.90 / $235.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.49 / $164.87 / $200.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.90 / $131.90 / $169.62