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Minnesota rates for HCPCS Q4124

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

Facilitymedian $15 · 10th–90th $2–$320%20%10th90th$15Professionalmedian $102 · 10th–90th $2–$1260%20%10th90th$102$0.2$1.0$5.0$20.0$100.0$500.0$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. 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 / $10.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.12 / $15.49 / $16.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $107.15 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $26.92 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $10.96 / $11.75
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $27.54 / $34.67
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $10.47
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.45 / $2.45 / $6.76
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2.45 / $2.45 / $9.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $125.89 / $239.88