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Idaho rates for HCPCS Q4158

Kerecis Omega3, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.31 / $66.31 / $66.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.31 / $74.00 / $84.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.47 / $67.27 / $67.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $67.27 / $67.27
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.31 / $84.09 / $107.64
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $71.31 / $84.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $78.00 / $124.06
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.73 / $80.73 / $80.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.27 / $67.27 / $67.27