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Alaska rates for HCPCS Q4225

AmnioBind or DermaBind TL, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,655.06 / $2,655.06 / $2,655.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,427.45 / $1,427.45 / $1,427.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,427.45 / $1,427.45 / $2,019.98
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,370.73 / $2,655.06 / $3,717.08
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,427.45 / $1,427.45 / $1,855.69
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,436.00 / $2,784.00 / $3,828.00
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,542.17 / $1,914.00 / $2,088.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,427.45 / $2,655.06 / $3,717.08
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,427.45 / $1,844.40 / $2,088.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,141.17 / $2,141.17 / $4,282.35