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Idaho rates for HCPCS Q4102

Oasis Wound Matrix

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.70 / $11.70 / $11.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.70 / $13.07 / $14.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.21 / $11.88 / $11.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.88 / $11.88 / $11.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.76 / $13.07 / $16.73
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.88 / $11.88 / $14.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.23 / $12.07 / $23.42
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.26 / $14.26 / $14.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.88 / $11.88 / $11.88