go back

Alaska rates for HCPCS Q4234

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,030.32 / $1,030.32 / $1,030.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$553.94 / $553.94 / $553.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.94 / $553.94 / $783.87
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.83 / $1,030.32 / $1,442.45
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.94 / $553.94 / $830.91
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$385.10 / $2,000.00 / $3,495.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,037.50 / $1,375.00 / $1,500.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$553.94 / $1,030.32 / $2,500.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.94 / $656.18 / $1,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$830.91 / $846.26 / $1,661.82