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Florida rates for HCPCS Q4157

Revitalon Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.65 / $173.93 / $173.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.65 / $173.93 / $178.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.13 / $178.13 / $178.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.13 / $178.13 / $178.13
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.13 / $178.13 / $178.13
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.76 / $163.51 / $178.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $50.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.90 / $202.90 / $202.90
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.08 / $155.08 / $155.08