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Missouri rates for HCPCS Q4257

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $933.25 / $1,737.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $912.01 / $1,071.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $120.23 / $549.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $144.54 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $912.01 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $912.01 / $912.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $912.01 / $1,949.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $645.65 / $3,630.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $660.69 / $776.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $489.78 / $1,659.59