go back

Texas rates for HCPCS Q4165

Keramatrix Or Kerasorb Per Square Centimeter (Desc Rvsd 10/1/19)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.59 / $43.66 / $43.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.59 / $43.66 / $45.25
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.84 / $100.84 / $121.37
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
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.12 / $53.24 / $92.56
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.10 / $205.54 / $302.94
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.59 / $53.24 / $92.56
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.25 / $45.25 / $45.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.36 / $44.36 / $44.36
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.19 / $8.19 / $11.06