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Alaska rates for HCPCS Q4108

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

Facilitymedian $58 · 10th–90th $35–$1660%10%20%10th90th$58Professionalmedian $42 · 10th–90th $38–$3020%20%40%10th90th$42$50.0$100.0$200.0$500.0$1.0K$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
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $46.77 / $102.33
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $302.00 / $512.86
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $104.71 / $165.96
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $83.18 / $89.13
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $46.77 / $144.54
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $60.26 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $107.15 / $316.23