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Oklahoma rates for HCPCS Q4204

Xwrap 1 Sq Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,987.51 / $3,987.51 / $3,987.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,987.51 / $3,987.51
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 / $3,692.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,774.77 / $4,076.76 / $5,907.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,929.02 / $3,774.77 / $12,996.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $4,071.32