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Georgia 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
$1,640.93 / $1,640.93 / $1,640.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,722.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,673.74
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $3,216.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.05 / $1,548.05 / $1,640.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $2,089.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,326.00 / $1,326.00 / $2,426.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.97 / $239.19 / $3,035.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $2,057.73