go back

Pennsylvania 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
$112.20 / $112.20 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $112.20 / $371.54
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $812.83 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $812.83 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $112.20 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $112.20 / $117.49
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $707.95 / $831.76
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $162.18 / $218.78
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $112.20 / $112.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $112.20 / $173.78
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $194.98 / $245.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $190.55 / $933.25