go back

Minnesota rates for HCPCS Q4254

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$938.00 / $938.00 / $938.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.88 / $355.88 / $412.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $612.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.39 / $395.76 / $408.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.24 / $1,086.48 / $1,527.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.76 / $457.89 / $500.16
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$525.10 / $995.69 / $1,376.18
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.83 / $393.83 / $420.08
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.88 / $355.88 / $355.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $480.00 / $1,101.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $480.00 / $870.14