go back

North Dakota rates for HCPCS Q4201

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.09 / $76.09 / $76.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $76.09 / $76.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.62 / $77.18 / $83.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.63 / $153.63 / $176.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.98 / $88.85 / $109.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.23 / $110.92 / $145.66
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.23 / $79.23 / $88.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $76.09 / $105.44