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Illinois rates for HCPCS Q4220

BellaCell HD or SureDerm, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $125.89 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $117.49 / $134.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $208.93 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $154.88 / $186.21
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $169.82 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $33.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $128.82