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Florida rates for HCPCS Q4104

Integra bilayer matrix wound dressing (BMWD), per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $51 · 10th–90th $51–$3,9810%50%90th$51Professionalmedian $51 · 10th–90th $51–$1260%50%90th$51$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $56.23
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $107.15 / $125.89
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $97.72 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $85.11 / $131.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.22 / $15.49 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $81.28 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $125.89 / $125.89
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $10.47 / $128.82