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North Dakota rates for HCPCS Q4195

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.94 / $97.94 / $97.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $113.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.33 / $99.35 / $107.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.45 / $123.45 / $141.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.08 / $103.10 / $127.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.92 / $135.05 / $183.46
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.17 / $107.92 / $120.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.94 / $97.94 / $109.69