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Michigan rates for HCPCS Q4108

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

Facilitymedian $39 · 10th–90th $39–$1020%20%40%90th$39Professionalmedian $38 · 10th–90th $19–$740%50%10th90th$38$5.0$10.0$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
$38.90 / $38.90 / $38.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $45.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.72 / $17.38 / $17.38
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $17.38 / $17.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $125.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $67.61 / $186.21
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $67.61 / $138.04
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $125.89 / $125.89