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Maine rates for HCPCS Q4165

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

Facilitymedian $145 · 10th–90th $145–$3630%50%90th$145Professionalmedian $45 · 10th–90th $42–$1260%20%40%10th90th$45$10.0$50.0$200.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $43.65 / $52.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $125.89 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $54.95
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $43.65 / $52.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $107.15 / $138.04