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Idaho rates for HCPCS Q4166

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.85 / $20.85 / $20.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.97 / $21.97 / $24.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.84 / $19.97 / $19.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.97 / $19.97 / $19.97
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.56 / $24.96 / $31.95
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.97 / $21.17 / $24.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $37.63 / $55.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.96 / $23.96 / $23.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.97 / $19.97 / $19.97