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Tennessee 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
$44.19 / $44.19 / $77.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.59 / $44.19 / $45.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.97 / $35.95 / $38.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.25 / $45.25 / $45.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.25 / $45.25 / $45.25
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $106.48 / $134.93
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.72 / $202.31 / $212.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.14 / $44.36 / $44.36