go back

Georgia rates for HCPCS Q4204

Xwrap 1 Sq Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $3,692.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $3,876.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $3,765.98
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $7,236.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,483.15 / $3,483.15 / $3,692.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $4,702.26
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,907.00 / $2,907.00 / $4,749.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.97 / $239.19 / $6,830.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $4,482.63