go back

North Carolina rates for HCPCS Q4170

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $44.67 / $44.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.31 / $44.67 / $44.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.23 / $201.23 / $201.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.06 / $45.60 / $60.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.09 / $39.31 / $39.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.31 / $39.31 / $81.11
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $132.78 / $1,254.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.78 / $132.78 / $167.56
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.20 / $58.20 / $58.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.31 / $39.31 / $51.10
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$969.00 / $969.00 / $1,710.00
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,990.00 / $3,990.00 / $3,990.00