go back

Kansas 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
$2,297.30 / $2,297.30 / $2,297.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,673.75 / $2,297.30
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
$1,280.00 / $1,673.75 / $2,413.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $5,857.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,847.19