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North Dakota rates for HCPCS 0100T

Plmt Scjncl Rta Prosth&Pls&Impltj Intra-Oc Rta

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,328.27 / $1,328.27 / $10,000.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,328.27 / $1,829.31 / $1,829.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,328.27 / $2,198.75 / $3,984.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,816.91 / $3,217.63 / $4,906.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,008.00 / $11,008.00 / $11,008.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,807.76 / $2,951.13 / $4,634.47