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Wisconsin rates for HCPCS Q4125

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

Facilitymedian $138 · 10th–90th $100–$2570%50%10th90th$138Professionalmedian $138 · 10th–90th $126–$2880%50%10th90th$138$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $138.04 / $138.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $251.19 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $199.53 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $147.91 / $181.97
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $251.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $138.04 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $295.12 / $416.87
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $100.00
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Security Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $380.19
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $257.04 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $138.04