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Massachusetts rates for HCPCS Q4165

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

Facilitymedian $25 · 10th–90th $17–$3310%20%10th90th$25Professionalmedian $46 · 10th–90th $42–$1260%50%10th90th$46$20.0$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
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $43.65 / $52.48
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $295.12 / $707.95
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $660.69
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $19.50 / $25.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $269.15 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $177.83 / $6,918.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $83.18
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $295.12 / $707.95
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $6,918.31 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $45.71 / $134.90