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Montana rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Facilitymedian $575 · 10th–90th $437–$9770%20%10th90th$575Professionalmedian $741 · 10th–90th $724–$8910%50%10th90th$741$100.0$200.0$500.0$1.0K$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
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $741.31 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,000.00
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $549.54
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $549.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $758.58 / $1,288.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $309.03 / $1,380.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26