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North Dakota rates for HCPCS Q4122

DermACELL, DermACELL AWM or DermACELL AWM Porous, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $115 · 10th–90th $95–$1350%20%40%10th90th$115Professionalmedian $100 · 10th–90th $95–$1260%50%10th90th$100$0.1$0.5$2.0$10.0$50.0$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
$95.50 / $95.50 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $100.00 / $120.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $100.00 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $147.91 / $181.97
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $169.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $125.89 / $239.88