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Nebraska rates for HCPCS Q4142

XCM biologic tissue matrix, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $191 · 10th–90th $102–$2290%10%20%10th90th$191Professionalmedian $117 · 10th–90th $81–$1410%20%10th90th$117$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $117.49 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $147.91 / $181.97
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $162.18
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $125.89 / $138.04