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Arkansas 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
$786.36 / $786.36 / $786.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $688.07 / $786.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$792.45 / $792.45 / $792.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$792.45 / $792.45 / $975.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$618.21 / $655.29 / $655.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $655.29 / $710.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.77 / $655.29 / $747.04