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Wisconsin rates for HCPCS Q4128

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

Facilitymedian $65 · 10th–90th $30–$12,3030%10%20%10th90th$65Professionalmedian $31 · 10th–90th $29–$1660%50%10th90th$31$5.0$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
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $10,964.78 / $31,622.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $30.20 / $32.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $48.98 / $93.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $77.62 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $125.89 / $223.87
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.90 / $67.61
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $33.88
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $31.62 / $75.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $64.57
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $32.36
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $32.36 / $52.48
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $269.15 / $416.87
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $64.57 / $134.90
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.90 / $134.90
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
$40.74 / $50.12 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $57.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $125.89 / $134.90