go back

North Dakota 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
$355.88 / $355.88 / $355.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.88 / $355.88 / $412.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$418.94 / $471.24 / $510.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.78 / $616.78 / $709.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.83 / $408.00 / $492.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.88 / $355.88 / $605.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $480.00 / $537.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $480.00 / $521.29