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Maine rates for HCPCS Q4161

bio-ConneKt wound matrix, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,590.54 / $1,654.16 / $1,654.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,590.54 / $1,590.54 / $1,653.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,590.54 / $1,590.54 / $1,590.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,590.54 / $1,590.54 / $1,590.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,590.54 / $1,590.54 / $1,590.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,590.54 / $1,654.16 / $1,654.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,590.54 / $1,590.54 / $2,306.28