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Arkansas rates for HCPCS Q4164

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,969.11 / $1,969.11 / $1,969.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,722.98 / $1,969.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,780.26 / $1,780.26 / $1,780.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.31 / $1,780.26 / $1,780.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.05 / $1,640.93 / $1,640.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,702.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,476.84 / $1,640.93 / $1,673.75