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Virginia 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
$162.18 / $162.18 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $158.49 / $190.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $151.36 / $257.04
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $95.50 / $95.50
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $158.49 / $239.88
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $177.83 / $257.04
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $190.55 / $190.55
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $138.04 / $524.81
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $138.04 / $524.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $295.12 / $295.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $158.49 / $165.96