go back

North Dakota rates for HCPCS Q4221

Amnio Wrap2, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,961.00 / $1,961.00 / $1,961.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,961.00 / $1,961.00 / $1,980.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,768.43 / $1,989.21 / $2,154.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,213.71 / $3,213.71 / $3,695.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,052.00 / $2,072.52 / $2,565.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,961.00 / $2,451.05 / $3,529.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,961.00 / $1,961.00 / $2,196.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,961.00 / $1,961.00 / $2,129.73