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Nebraska rates for HCPCS Q4254

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.88 / $355.88 / $391.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$342.46 / $402.89 / $402.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.75 / $402.88 / $402.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$408.00 / $408.00 / $408.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.83 / $418.78 / $560.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.88 / $355.88 / $797.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $480.00 / $528.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$418.78 / $480.43 / $576.48
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$418.78 / $480.43 / $576.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.00 / $480.00 / $480.00