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Arizona 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
Facility
Modifier
Low / Median / High Price
$698.04 / $698.04 / $766.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $352.51 / $383.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$290.70 / $686.81 / $1,698.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.26 / $363.39 / $858.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.26 / $349.01 / $349.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.01 / $349.01 / $349.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$347.55 / $418.82 / $810.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.55 / $356.55 / $773.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $349.02