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Montana rates for HCPCS Q4159

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

Facilitymedian $331 · 10th–90th $209–$1,0960%20%10th90th$331Professionalmedian $204 · 10th–90th $166–$4170%50%10th90th$204$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $257.04
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $302.00 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $302.00
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $363.08 / $812.83
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $363.08 / $812.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $239.88 / $446.68
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $181.97 / $831.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89