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Georgia rates for HCPCS Q4165

Keramatrix or Kerasorb, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $43.65 / $43.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $43.65 / $52.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $3,981.07 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $45.71 / $45.71
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $128.82 / $186.21
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $194.98 / $239.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,168.69 / $8,128.31 / $11,481.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $67.61 / $131.83