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Kansas rates for HCPCS Q4174

PalinGen or ProMatrX, 0.36 mg per 0.25 cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,494.00 / $1,494.00 / $1,494.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,195.20 / $1,195.20 / $1,494.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,269.90 / $1,269.90 / $1,269.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,269.90 / $1,269.90 / $1,269.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,195.20 / $1,494.00 / $1,628.46
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,245.00 / $1,245.00 / $5,677.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,245.00 / $1,245.00 / $1,401.50