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Kentucky rates for HCPCS Q4124

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

Facilitymedian $3 · 10th–90th $2$850%20%10th90th$3Professionalmedian $2 · 10th–90th $2$120%50%90th$2$2.0$10.0$50.0$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
Setting
Facility
Modifier
Global
Typical Low
$2.00
Median
$2.00
Typical High
$2.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2.00
Median
$2.00
Typical High
$3.02
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.51
Typical High
$10.00
CareSource
Setting
Facility
Modifier
Global
Typical Low
$2.51
Median
$2.51
Typical High
$3.98
CareSource
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.63
Typical High
$3.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$12.30
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$2.57
Median
$2.57
Typical High
$3.47
United
Setting
Facility
Modifier
Global
Typical Low
$16.22
Median
$16.22
Typical High
$102.33
United
Setting
Professional
Modifier
Global
Typical Low
$9.12
Median
$125.89
Typical High
$125.89