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Pennsylvania rates for HCPCS Q4256

Mlg complet, per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.05 / $742.40 / $2,146.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $735.05 / $742.40
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$624.78 / $735.04 / $1,102.56
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.04 / $735.04 / $735.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.05 / $735.05 / $735.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $735.05 / $762.78
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$624.79 / $735.05 / $938.92
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$735.05 / $821.35 / $2,146.87
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $735.05 / $821.35
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$693.44 / $735.05 / $735.05
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $735.05 / $936.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $735.05 / $1,345.14