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Minnesota rates for HCPCS Q4110

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.41 / $65.41 / $65.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.41 / $65.41 / $70.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $65.41 / $106.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.06 / $62.14 / $65.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.04 / $183.84 / $258.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.30 / $77.48 / $84.63
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.85 / $168.48 / $232.86
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.64 / $66.64 / $71.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.28 / $65.41 / $117.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.41 / $65.41 / $150.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.41 / $65.41 / $129.04