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Idaho rates for HCPCS 15004

Prep Site F/S/N/H/F/G/M/D Gt 1st 100 Sq Cm/1pct

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,628.00 / $4,500.00 / $7,607.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.16 / $399.15 / $606.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.53 / $445.65 / $649.91
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$279.14 / $434.53 / $642.85
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.84 / $627.12 / $760.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $611.85
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,016.89 / $1,451.69 / $1,937.47
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$394.37 / $511.29 / $737.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,800.00 / $8,244.00 / $9,193.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.10 / $524.70 / $686.41