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Montana rates for HCPCS Q4140

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

Facilitymedian $195 · 10th–90th $162–$3550%20%10th90th$195Professionalmedian $162 · 10th–90th $126–$1860%50%10th90th$162$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
$162.18 / $162.18 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $194.98 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $194.98
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $181.97 / $426.58
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89