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Colorado rates for HCPCS Q4124

OASIS ultra tri-layer wound matrix, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $28 · 10th–90th $2–$1450%20%10th90th$28Professionalmedian $2 · 10th–90th $2–$1170%50%90th$2$2.0$5.0$10.0$20.0$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
Facility
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $2.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.00 / $2.00 / $3.02
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.51 / $2.51 / $2.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.51 / $2.51 / $12.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $144.54 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $190.55 / $213.80
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $134.90 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $125.89 / $125.89