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Nebraska rates for HCPCS Q4155

Neox Flo or Clarix Flo 1 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.62 / $26.62 / $27.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.62 / $26.62 / $26.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.61 / $28.63 / $30.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.62 / $29.84 / $30.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.62 / $26.81 / $33.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.40 / $51.89 / $126.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.31 / $27.31 / $30.04
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.42 / $31.57 / $40.52
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.42 / $32.77 / $43.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.29 / $26.62 / $29.28