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North Dakota rates for HCPCS Q4165

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.59 / $42.59 / $42.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.59 / $44.19 / $53.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.72 / $43.55 / $47.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.25 / $45.25 / $45.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.59 / $42.59 / $74.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.36 / $44.36 / $49.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.36 / $44.36 / $48.18