go back

Nebraska 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 / $3,774.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $4,061.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,016.98 / $4,179.87 / $4,179.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,970.88 / $4,179.85 / $4,273.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $3,692.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,514.82 / $3,692.14 / $9,436.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,774.77 / $5,850.89 / $7,172.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,929.02 / $3,774.77 / $3,867.34
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,514.82 / $3,514.82 / $4,529.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,514.82 / $4,510.68 / $4,529.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $3,692.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,507.53 / $3,692.14 / $3,867.34