go back

California rates for HCPCS Q4233

SurFactor or NuDyn, per 0.5 cc

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,120.10 / $5,120.10 / $5,120.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.50 / $487.50 / $487.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.00 / $393.93 / $801.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.00 / $85.00 / $85.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,120.10 / $5,120.10 / $11,469.05
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,800,000.00 / $2,400,000.00 / $2,400,000.00