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Missouri rates for HCPCS Q4176

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.00 / $199.50 / $199.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.00 / $152.00 / $161.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.92 / $121.74 / $143.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.50 / $161.50 / $161.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.50 / $161.50 / $161.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.00 / $190.00 / $367.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.51 / $167.51 / $722.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.51 / $167.51 / $204.86