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North Dakota rates for HCPCS Q4191

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$655.29 / $655.29 / $655.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $655.29 / $661.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$590.95 / $664.73 / $719.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,015.32 / $2,015.32 / $2,317.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$834.58 / $967.48 / $1,197.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$730.43 / $982.95 / $1,351.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$730.43 / $730.43 / $940.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.29 / $655.29 / $711.69