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Utah rates for HCPCS Q4166

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

Facilitymedian $23 · 10th–90th $23–$310%50%90th$23Professionalmedian $21 · 10th–90th $19–$1260%20%10th90th$21$20.0$50.0$100.0$200.0$500.0

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
$22.91 / $22.91 / $22.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $19.95 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $30.20 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $141.25 / $162.18
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $19.95 / $125.89
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $169.82 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89