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Kentucky 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
$655.29 / $655.29 / $655.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $655.29 / $661.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $655.29 / $730.43
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$655.29 / $917.42 / $1,048.48
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $720.83 / $950.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$655.29 / $1,537.00 / $1,537.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $655.29 / $1,067.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $977.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $655.29 / $730.43