go back

Indiana rates for HCPCS Q4183

Surgigraft Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.00 / $80.00 / $81.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.00 / $85.00 / $95.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.51 / $66.51 / $91.15
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.51 / $79.81 / $99.77
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.91 / $160.91 / $172.35