go back

Illinois rates for HCPCS Q4183

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $105.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.00 / $80.00 / $85.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.00 / $320.88 / $1,590.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.00 / $200.00 / $345.40
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $40.00 / $2,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.91 / $160.91 / $170.74