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Kentucky 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 / $83.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.00 / $80.00 / $80.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.11 / $93.11 / $93.12
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.98 / $76.48 / $93.12
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
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $45.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.91 / $160.91 / $172.35