go back

Kentucky rates for HCPCS Q4256

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.05 / $735.05 / $735.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $735.05 / $742.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $735.05 / $829.47
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.05 / $992.32 / $1,176.08
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $808.56 / $1,065.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.05 / $1,887.00 / $1,887.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $735.05 / $1,188.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $972.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $735.05 / $813.21