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North Dakota rates for HCPCS Q4132

Grafix Core and GrafixPL Core, per sq cm (add-on, list separately in addition to primary procedure)

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 / $107.77
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.22 / $108.24 / $117.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$241.15 / $241.15 / $277.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.21 / $47.77 / $106.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.18 / $117.92 / $192.06
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.50 / $89.18 / $99.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.70 / $106.70 / $119.50