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North Dakota rates for HCPCS Q4164

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,640.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,657.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.79 / $1,664.53 / $1,802.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,609.08 / $2,609.08 / $3,000.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.24 / $410.30 / $1,640.93
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,640.93 / $2,051.17 / $2,953.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.14 / $1,640.93 / $1,837.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,640.93 / $1,640.93 / $1,782.13