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Nebraska rates for HCPCS Q4169

Artacent wound, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,068.46 / $2,068.46 / $2,220.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,068.46 / $2,068.46 / $2,275.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,990.46 / $2,341.71 / $2,341.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,224.63 / $2,341.71 / $2,513.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,068.46 / $2,068.46 / $2,068.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.71 / $324.27 / $2,068.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$394.37 / $2,664.69 / $4,219.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,220.57 / $2,220.57 / $3,434.86
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$202.71 / $237.68 / $2,664.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.71 / $271.48 / $2,664.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,965.05 / $2,068.46 / $3,102.71