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Montana rates for HCPCS Q4121

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

Facilitymedian $52 · 10th–90th $28–$1350%20%10th90th$52Professionalmedian $52 · 10th–90th $52–$1260%50%90th$52$50.0$100.0$200.0

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
$52.48 / $52.48 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $61.66 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $58.88 / $125.89
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $48.98 / $87.10
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.44 / $48.98 / $87.10
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $58.88 / $181.97
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $79.43 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89