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Idaho rates for HCPCS Q4165

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

Facilitymedian $60 · 10th–90th $45–$1450%10%20%10th90th$60Professionalmedian $45 · 10th–90th $31–$1620%20%10th90th$45$20.0$50.0$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
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $43.65 / $63.10
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $16.98 / $17.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $53.70 / $144.54
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $218.78 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $77.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $151.36
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $117.49 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89