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Montana rates for HCPCS Q4132

Grafix Core and GrafixPL Core, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $129 · 10th–90th $107–$3980%20%10th90th$129Professionalmedian $110 · 10th–90th $107–$1660%50%10th90th$110$50.0$100.0$200.0$500.0

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
$107.15 / $107.15 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $144.54 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $125.89 / $181.97
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $128.82 / $467.74
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $128.82 / $467.74
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $128.82 / $354.81
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $85.11 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89