go back

Arizona 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
$1,805.02 / $1,805.02 / $1,805.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,657.34 / $1,805.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$259.77 / $613.74 / $1,517.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.83 / $324.73 / $767.17
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 / $1,640.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,599.91 / $1,805.02 / $3,664.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $3,560.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,640.93