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Idaho rates for HCPCS Q4169

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,220.57 / $2,220.57 / $2,220.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,068.46 / $2,275.32 / $2,585.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,951.39 / $2,068.46 / $2,068.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,068.46 / $2,068.46 / $2,068.46
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.16 / $2,585.59 / $3,309.56
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,068.46 / $2,109.84 / $2,585.59
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $78.00 / $343.32
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,482.17 / $2,482.17 / $2,482.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,068.46 / $2,068.46 / $2,068.46