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Oregon rates for HCPCS Q4234

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.83 / $194.83 / $194.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.94 / $553.94 / $598.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.04 / $495.84 / $522.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.94 / $553.94 / $653.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.95 / $474.86 / $730.85
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.83 / $553.94 / $1,375.00
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.94 / $587.16 / $720.12
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.83 / $553.92 / $1,046.95
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.93 / $553.94 / $1,375.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.93 / $653.23 / $2,250,000.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.24 / $553.94 / $553.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.94 / $553.94 / $637.03