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Idaho rates for HCPCS Q4113

Graftjacket Xpress

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.88 / $762.88 / $762.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.00 / $762.88 / $771.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.88 / $762.88 / $762.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.88 / $762.88 / $762.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$434.81 / $771.85 / $976.49
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.06 / $358.06 / $358.06
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $78.00 / $3,900.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,997.50 / $1,997.50 / $2,796.50