go back

Alaska rates for HCPCS Q4158

Kerecis Omega3, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.13 / $125.13 / $125.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.27 / $67.27 / $67.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $67.27 / $95.20
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.31 / $125.13 / $178.94
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $67.27 / $87.45
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$285.19 / $325.94 / $3,495.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.08 / $224.08 / $244.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.27 / $125.13 / $410.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $97.75 / $246.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.91 / $100.91 / $201.81