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Kansas 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
$918.57 / $918.57 / $918.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.12 / $669.25 / $918.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$618.98 / $618.98 / $656.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.12 / $656.12 / $656.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$700.00 / $1,111.86 / $1,658.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,090.07 / $1,090.07 / $5,838.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.12 / $656.12 / $951.37