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Minnesota rates for HCPCS Q4103

Oasis Burn Matrix

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.49 / $12.49 / $12.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.49 / $12.49 / $12.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $12.73 / $23.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.90 / $12.38 / $12.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.25 / $35.38 / $49.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.92 / $14.91 / $16.23
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.10 / $32.43 / $44.82
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.79 / $12.79 / $13.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.06 / $12.38 / $27.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.38 / $12.38 / $28.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.49 / $12.49 / $22.64