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Maine rates for HCPCS Q4156

Neox 100 Or Clarix 100 Per Square Centimeter (Desc Revised 1/1/2018)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $68.52 / $68.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $65.88 / $66.34
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 / $65.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $65.88 / $65.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $68.52 / $68.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $65.88 / $115.29