go back

Rhode Island rates for HCPCS Q4219

SurgiGRAFT-DUAL, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,000.00 / $1,202.26
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $281.84 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,023.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $794.33 / $794.33