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Pennsylvania rates for HCPCS Q4128

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

Facilitymedian $4,677 · 10th–90th $30–$22,3870%10%10th90th$4,677Professionalmedian $30 · 10th–90th $29–$1260%50%10th90th$30$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
$30.20 / $5,623.41 / $22,387.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $33.88
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $104,712.85 / $134,896.29
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $30.20 / $37.15
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $446.68 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $30.20 / $263.03
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $151.36 / $208.93
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $66.07 / $5,128.61
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $63,095.73 / $107,151.93
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $45.71 / $177.83
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $28.84 / $30.90
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $229.09 / $245.47
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $34.67 / $309.03
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $33.11 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $125.89 / $134.90