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North Dakota rates for HCPCS Q4203

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

Facilitymedian $1,047 · 10th–90th $871–$1,4790%50%10th90th$1,047Professionalmedian $1,047 · 10th–90th $851–$1,2300%50%10th90th$1,047$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,230.27
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $977.24 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $309.03 / $380.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,096.48 / $1,905.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $870.96 / $954.99
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $316.23