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Iowa rates for HCPCS Q4194

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $660.69 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $245.47 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $741.31 / $912.01
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $676.08 / $1,380.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $933.25 / $2,238.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $724.44 / $1,288.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,096.48 / $2,238.72
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $257.04 / $302.00
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $1,202.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.72 / $724.44 / $1,174.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $724.44 / $1,000.00
Wellmark
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $660.69 / $660.69
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $660.69