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Montana rates for HCPCS Q4114

Integra flowable wound matrix, injectable, 1 cc

Facilitymedian $1,698 · 10th–90th $1,514–$2,8180%20%40%10th90th$1,698Professionalmedian $2,344 · 10th–90th $1,698–$2,8180%50%10th90th$2,344$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$2,238.72 / $2,344.23 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,398.83 / $2,398.83
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,659.59 / $2,951.21
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,659.59 / $2,951.21
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,995.26 / $2,818.38
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,698.24 / $2,398.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $2,818.38