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Illinois rates for HCPCS Q4191

Restorigin, per square centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$655.29 / $655.29 / $1,837.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $655.29 / $720.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,064.32 / $1,064.32 / $1,277.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$655.29 / $655.29 / $655.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $655.29 / $865.49
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.01 / $832.23 / $1,840.36
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.89 / $851.89 / $851.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $40.00 / $1,382.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $655.29 / $744.64