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Florida rates for HCPCS Q4157

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

Facilitymedian $174 · 10th–90th $126–$2000%50%10th90th$174Professionalmedian $174 · 10th–90th $126–$1820%50%10th90th$174$2.0$10.0$50.0$200.0$1.0K

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
$165.96 / $173.78 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $173.78 / $177.83
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $123.03 / $131.83
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $128.82 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $107.15 / $177.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $60.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $204.17 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $204.17
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $154.88 / $154.88