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Ohio 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 / $172.00
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 / $74.16 / $112.86
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.99 / $88.99 / $151.28
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.92 / $88.99 / $88.99
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
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.50 / $161.50 / $161.50
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.50 / $161.50 / $190.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.92 / $79.10 / $95.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.51 / $167.51 / $233.02