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Idaho rates for HCPCS Q4108

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

Facilitymedian $50 · 10th–90th $30–$1410%10%10th90th$50Professionalmedian $42 · 10th–90th $38–$1580%20%10th90th$42$20.0$50.0$100.0$200.0

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
$117.49 / $117.49 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $52.48
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $40.74 / $66.07
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $323.59
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
$22.39 / $44.67 / $107.15
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $218.78 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $77.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $151.36
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $117.49 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $125.89 / $125.89