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Montana rates for HCPCS Q4193

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,819.70 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,737.80 / $1,949.84
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $1,445.44 / $2,630.27
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $125.89 / $2,454.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $165.96 / $1,949.84