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Utah rates for HCPCS Q4217

Woundfix Biowound Woundfix Plus Biowound Plus Woundfix Xplus Or Biowound Xplus Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$368.88 / $368.88 / $368.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.00 / $349.80 / $397.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.67 / $489.82 / $650.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.00 / $318.00 / $318.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $45.00 / $60.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.82 / $349.80 / $349.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.00 / $318.00 / $318.00