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Minnesota rates for HCPCS Q4153

Dermavest And Plurivest Per Square Centimeter (Revised 01/01/2016)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.93 / $137.93 / $137.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $137.93 / $143.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $349.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.88 / $108.60 / $116.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.45 / $434.51 / $610.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.81 / $163.13 / $183.12
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.00 / $398.20 / $550.37
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.50 / $130.50 / $168.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.60 / $108.60 / $248.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.60 / $108.60 / $249.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.93 / $137.93 / $250.04