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Utah rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Facilitymedian $741 · 10th–90th $741–$7410%50%$741Professionalmedian $741 · 10th–90th $724–$8910%50%10th90th$741$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $741.31 / $741.31
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 / $758.58
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $75.86 / $363.08
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $707.95
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26