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Arkansas rates for HCPCS Q4190

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $112.20 / $134.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $123.03 / $123.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $112.20 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $112.20 / $125.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $562.34 / $812.83