go back

Florida rates for HCPCS Q4180

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$656.12 / $656.12 / $1,090.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.12 / $656.12 / $820.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$618.98 / $656.12 / $656.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.12 / $656.12 / $656.12
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$656.12 / $656.12 / $656.12
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.12 / $656.12 / $702.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $70.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.12 / $656.12 / $662.68
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.12 / $1,090.07 / $1,090.07