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Alabama rates for HCPCS Q4191

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $660.69 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $660.69 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $660.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $1,737.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $1,023.29 / $1,737.80