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Idaho rates for HCPCS Q4137

AmnioExcel, AmnioExcel Plus or BioDExcel, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.72 / $100.72 / $100.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.72 / $111.89 / $127.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.96 / $101.72 / $101.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.72 / $101.72 / $101.72
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.72 / $127.15 / $162.75
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.72 / $107.82 / $127.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.96 / $105.01 / $199.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.06 / $122.06 / $122.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.72 / $101.72 / $162.75