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Montana rates for HCPCS Q4110

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

Facilitymedian $69 · 10th–90th $40–$1820%50%10th90th$69Professionalmedian $66 · 10th–90th $65–$1260%50%10th90th$66$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$64.57 / $64.57 / $117.49
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $74.13 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $181.97
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $67.61 / $75.86
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $67.61 / $75.86
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $72.44 / $181.97
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $79.43 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89