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Idaho rates for HCPCS Q4178

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.11 / $93.11 / $93.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.41 / $98.35 / $111.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.35 / $89.41 / $89.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.41 / $89.41 / $89.41
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.30 / $111.76 / $143.05
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.41 / $94.77 / $111.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $78.00 / $179.46
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.29 / $107.29 / $107.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.41 / $89.41 / $89.41