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Idaho rates for HCPCS Q4227

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,165.39 / $1,165.39 / $1,165.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,165.39 / $1,289.81 / $1,465.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,106.19 / $1,172.56 / $1,172.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,172.56 / $1,172.56 / $1,172.56
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.14 / $1,465.70 / $1,876.10
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,172.56 / $1,289.82 / $1,465.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $78.00 / $2,325.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,172.56 / $1,172.56 / $1,172.56