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Idaho rates for HCPCS Q4156

Neox 100 or Clarix 100, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.34 / $66.34 / $66.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $72.47 / $82.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.15 / $65.88 / $65.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $65.88 / $65.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.34 / $82.35 / $105.41
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $69.83 / $82.35
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $78.00 / $126.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.06 / $79.06 / $79.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.88 / $65.88 / $92.23