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Nevada rates for HCPCS Q4157

Revitalon, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.93 / $173.93 / $178.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.65 / $173.93 / $178.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.13 / $178.13 / $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
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.38 / $201.26 / $222.92
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.38 / $127.38 / $191.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.90 / $202.90 / $202.90