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Minnesota rates for HCPCS Q4132

Grafix Core And Grafixpl Core Per Square Centimeter (Desc Revised 1/1/2018)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.70 / $106.70 / $106.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.70 / $106.70 / $123.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $155.08 / $270.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.34 / $89.18 / $158.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.16 / $424.79 / $597.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.59 / $47.77 / $106.70
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$202.67 / $389.29 / $538.04
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.21 / $38.21 / $51.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.18 / $89.18 / $196.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.18 / $89.18 / $204.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.70 / $106.70 / $193.64