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Indiana 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
$352.51 / $352.51 / $360.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $360.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$349.01 / $349.01 / $673.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.01 / $349.01 / $495.59
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$349.02 / $349.02 / $523.53
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $418.82
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 / $688.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $466.22