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Alaska rates for HCPCS Q4217

WoundFix, BioWound, WoundFix Plus, BioWound Plus, WoundFix Xplus or BioWound Xplus, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591.48 / $591.48 / $591.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.00 / $318.00 / $318.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.00 / $318.00 / $450.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.00 / $591.48 / $845.82
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.00 / $318.00 / $1,015.50
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$559.79 / $2,320.00 / $3,495.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,203.50 / $1,595.00 / $1,740.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.00 / $591.48 / $2,900.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.00 / $463.58 / $1,815.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.00 / $485.81 / $954.00