go back

Iowa rates for HCPCS Q4259

Celera Dual Layer or Celera Dual Membrane, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.50 / $713.50 / $720.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$993.68 / $1,242.08 / $1,664.96
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.48 / $1,020.30 / $1,744.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$941.46 / $1,590.00 / $1,664.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$941.46 / $941.46 / $1,882.92
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,129.75 / $1,252.70 / $1,921.10
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,129.75 / $1,252.70 / $1,921.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,609.18 / $1,609.18 / $1,609.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.50 / $713.50 / $784.85
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$941.46 / $941.46 / $941.46
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$743.75 / $941.46 / $941.46