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Wyoming 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
$813.21 / $813.21 / $813.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $801.20 / $808.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,887.00 / $2,220.00 / $2,220.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$693.44 / $693.44 / $693.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $1,040.16 / $1,040.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.05 / $735.05 / $735.05