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North Carolina 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
$114.82 / $114.82 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $158.49 / $162.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $144.54 / $151.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $89.13 / $97.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $158.49 / $223.87
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $194.98 / $245.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $295.12 / $331.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $165.96 / $165.96
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14