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Montana rates for HCPCS Q4161

bio-ConneKt wound matrix, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $245 · 10th–90th $135–$2,1380%20%10th90th$245Professionalmedian $1,585 · 10th–90th $126–$1,7380%50%10th90th$1,585$100.0$200.0$500.0$1.0K$2.0K

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
$616.60 / $1,584.89 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $2,137.96 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $2,137.96
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $269.15
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $269.15
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $1,621.81 / $2,951.21
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $3,090.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89