go back

Tennessee 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 / $2,871.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,722.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,560.00 / $1,780.26 / $1,857.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,640.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,640.93
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,773.90 / $2,631.69 / $5,493.04
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,460.00 / $5,857.77 / $6,941.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,558.88 / $1,640.93 / $1,640.93