go back

Idaho rates for HCPCS Q4176

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $117.49 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $158.49 / $162.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $154.88 / $154.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $173.78 / $281.84
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $218.78 / $251.19
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $77.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $151.36 / $151.36
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $117.49 / $123.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $165.96