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Montana rates for HCPCS Q4170

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

Facilitymedian $71 · 10th–90th $56–$1,1480%20%10th90th$71Professionalmedian $40 · 10th–90th $39–$1260%20%40%10th90th$40$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$38.90 / $38.90 / $117.49
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $79,432.82 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $512.86 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $512.86
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $61.66 / $102.33
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $61.66 / $102.33
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $72.44 / $512.86
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $776.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89