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Montana rates for HCPCS Q4169

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

Facilitymedian $309 · 10th–90th $240–$2,1380%20%40%10th90th$309Professionalmedian $2,089 · 10th–90th $158–$2,2910%50%10th90th$2,089$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $2,089.30 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $199.53 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $199.53
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $537.03
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $537.03
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $2,089.30 / $3,467.37
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $85.11 / $3,467.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89