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Alaska rates for HCPCS Q4173

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$649.16 / $649.16 / $649.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$349.01 / $349.01 / $349.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.01 / $349.01 / $493.89
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$356.55 / $649.16 / $908.84
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $523.53
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,134.00 / $1,296.00 / $3,495.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$688.50 / $891.00 / $972.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$349.02 / $649.16 / $1,620.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.01 / $429.39 / $972.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$523.53 / $523.53 / $1,047.06