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Arizona rates for HCPCS Q4165

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

Facilitymedian $69 · 10th–90th $41–$2240%5%10%10th90th$69Professionalmedian $44 · 10th–90th $42–$1260%20%40%10th90th$44$20.0$100.0$500.0$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
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $43.65 / $47.86
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $72.44 / $234.42
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $63.10 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $47.86 / $91.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $95.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $6,918.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $125.89 / $125.89