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Minnesota rates for HCPCS Q4157

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

Facilitymedian $245 · 10th–90th $162–$3890%20%40%10th90th$245Professionalmedian $126 · 10th–90th $107–$1780%20%10th90th$126$0.2$1.0$5.0$20.0$100.0$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
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $173.78 / $208.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $245.47 / $257.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $125.89 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $162.18 / $186.21
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $380.19 / $549.54
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $158.49
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $208.93 / $208.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $288.40