go back

North Dakota rates for HCPCS Q4111

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.87 / $7.87 / $7.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.87 / $7.87 / $9.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.10 / $7.98 / $8.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.57 / $11.57 / $13.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.46 / $7.87 / $9.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.97 / $7.12 / $14.17
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.12 / $7.12 / $7.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.87 / $7.87 / $8.81