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Alaska rates for HCPCS Q4156

Neox 100 or Clarix 100, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.54 / $122.54 / $122.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.88 / $65.88 / $65.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $65.88 / $93.23
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.34 / $122.54 / $175.23
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $65.88 / $85.64
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.67 / $288.00 / $3,495.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.67 / $198.00 / $216.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.88 / $122.54 / $360.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $80.06 / $216.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.82 / $98.82 / $197.64