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Ohio 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
$349.02 / $349.02 / $684.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $359.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $401.37 / $677.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$349.02 / $349.02 / $593.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $471.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.26 / $329.26 / $349.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.01 / $349.01 / $493.89
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$688.50 / $688.50 / $688.50
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.01 / $349.01 / $587.92
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.55 / $432.61 / $516.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $448.84