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Alabama rates for HCPCS Q4205

Membrane Graft Or Membrane Wrap Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,237.28 / $1,237.28 / $1,237.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,237.28 / $1,237.28 / $1,361.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,237.28 / $1,237.28 / $1,237.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,237.28 / $1,237.28 / $1,237.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,055.97 / $1,237.28 / $1,237.28