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North Dakota rates for HCPCS Q4247

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,944.00 / $2,944.00 / $2,944.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,944.00 / $3,054.40 / $3,680.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,792.92 / $3,141.60 / $3,402.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$845.71 / $845.71 / $972.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.00 / $675.00 / $3,128.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$636.00 / $1,334.00 / $2,267.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,240.00 / $3,200.00 / $3,584.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,720.00 / $3,200.00 / $3,475.36