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Wisconsin rates for HCPCS Q4110

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

Facilitymedian $68 · 10th–90th $66–$2340%20%40%10th90th$68Professionalmedian $68 · 10th–90th $65–$1260%50%10th90th$68$5.0$20.0$100.0$500.0$2.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $70.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $79.43 / $97.72
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $165.96 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $104.71 / $125.89
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $144.54
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $74.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $67.61 / $147.91
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $363.08
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $50.12 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $69.18 / $112.20
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $229.09 / $416.87
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $85.11 / $288.40
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $74.13 / $288.40
Security Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $380.19
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $89.13 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $125.89 / $134.90