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North Dakota rates for HCPCS Q4128

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.91 / $29.91 / $29.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $30.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.97 / $30.34 / $32.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.69 / $48.69 / $55.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.94 / $29.91 / $31.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.70 / $38.40 / $53.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.47 / $30.70 / $34.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.91 / $29.91 / $32.47