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Maine rates for HCPCS Q4125

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

Facilitymedian $2,512 · 10th–90th $363–$2,5120%50%10th$2,512Professionalmedian $138 · 10th–90th $126–$1380%50%10th$138$10.0$50.0$200.0$1.0K

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
$2,511.89 / $2,511.89 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $125.89 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $177.83
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $125.89 / $173.78