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New Hampshire rates for HCPCS Q4158

Kerecis Omega3, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $81 · 10th–90th $68–$2690%20%10th90th$81Professionalmedian $68 · 10th–90th $68–$1780%50%90th$68$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$67.61 / $81.28 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $89.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $251.19 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $125.89 / $125.89
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $281.84