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Pennsylvania rates for HCPCS Q4164

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

Facilitymedian $1,622 · 10th–90th $214–$1,6600%50%10th90th$1,622Professionalmedian $1,622 · 10th–90th $174–$1,7380%50%10th90th$1,622$1.0$10.0$100.0$1.0K$10.0K

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
$1,621.81 / $1,659.59 / $1,659.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,819.70
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,288.25 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $446.68 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $263.03 / $1,318.26
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $151.36 / $213.80
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,659.59
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,737.80
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $194.98 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,318.26