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New Hampshire rates for HCPCS Q4108

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

Facilitymedian $47 · 10th–90th $39–$2510%20%10th90th$47Professionalmedian $39 · 10th–90th $38–$740%50%10th90th$39$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 / $46.77 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.90 / $47.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $63.10 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $251.19 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $38.90 / $70.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $50.12 / $125.89
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $91.20 / $102.33