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Arizona rates for HCPCS Q4219

Surgigraft-Dual Per Square Centimeter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$972.00 / $972.00 / $972.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$960.00 / $972.00 / $996.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.48 / $190.13 / $470.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.73 / $100.60 / $237.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,020.00 / $1,020.00 / $1,020.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,020.00 / $1,020.00 / $1,020.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$972.00 / $1,137.24 / $1,973.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$788.99 / $788.99 / $1,712.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$788.99 / $788.99 / $788.99