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North Dakota rates for HCPCS Q4104

Integra bilayer matrix wound dressing (BMWD), per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $51 · 10th–90th $51–$910%50%90th$51Professionalmedian $52 · 10th–90th $51–$790%50%10th90th$52$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $70.79
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $61.66 / $77.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $63.10 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $53.70 / $91.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $53.70 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $239.88