go back

North Dakota 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
$663.63 / $663.63 / $663.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.63 / $663.63 / $670.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$598.46 / $673.17 / $728.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,373.87 / $1,373.87 / $1,579.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$732.94 / $740.27 / $916.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$717.78 / $897.21 / $1,213.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$717.78 / $717.78 / $803.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.63 / $663.63 / $743.27