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Minnesota rates for HCPCS Q4173

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$349.02 / $349.02 / $349.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $362.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1,227.93 / $2,777.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.07 / $338.72 / $356.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$525.41 / $965.55 / $1,357.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.99 / $407.72 / $466.49
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$466.65 / $884.86 / $1,223.00
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.31 / $367.31 / $373.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$356.55 / $356.55 / $785.55
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.55 / $356.55 / $817.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $688.53