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North Dakota rates for HCPCS Q4188

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.59 / $487.59 / $487.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $492.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.70 / $494.60 / $535.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,153.16 / $1,153.16 / $1,326.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.85 / $487.59 / $502.31
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.59 / $682.63 / $877.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $546.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.64 / $487.59 / $529.54