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Idaho rates for HCPCS 11004

Dbrdmt Skn Sbq T/M/F Necro Infctj Xtrnl Gent&Per

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $5,519.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.00 / $771.93 / $983.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,700.00 / $15,298.00 / $26,104.00