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Nebraska 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 / $152.00 / $152.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.00 / $152.00 / $161.50
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.44 / $74.63 / $74.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.90 / $74.62 / $74.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.50 / $161.50 / $161.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.84 / $152.53 / $204.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.80 / $228.00 / $288.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.51 / $167.51 / $177.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$82.86 / $152.53 / $204.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.86 / $152.53 / $204.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.13 / $167.51 / $177.60