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Minnesota rates for HCPCS Q4108

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.54 / $38.54 / $38.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $40.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $50.48 / $84.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.29 / $46.66 / $49.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.72 / $131.80 / $185.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.93 / $56.06 / $65.29
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.70 / $120.79 / $166.95
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.96 / $51.41 / $51.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.61 / $49.12 / $88.42
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.12 / $49.12 / $112.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.54 / $38.54 / $76.03