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Indiana rates for HCPCS Q4108

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

Facilitymedian $245 · 10th–90th $39–$5130%10%10th90th$245Professionalmedian $39 · 10th–90th $38–$980%50%10th90th$39$20.0$50.0$100.0$200.0$500.0

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
$38.02 / $38.90 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $41.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $263.03 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $69.18
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $46.77 / $69.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $346.74 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $125.89 / $125.89