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Wyoming 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 / $1,788.61 / $1,805.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,326.00 / $1,560.00 / $1,560.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.05 / $1,548.05 / $1,548.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $2,322.07 / $2,322.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,640.93