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Montana rates for HCPCS Q4128

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

Facilitymedian $32 · 10th–90th $30–$1450%50%10th90th$32Professionalmedian $31 · 10th–90th $29–$1260%50%10th90th$31$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $30.20 / $117.49
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $125.89 / $181.97
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $60.26
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $60.26
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $30.90 / $181.97
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $79.43 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89