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Utah rates for HCPCS Q4170

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

Facilitymedian $45 · 10th–90th $45–$5130%50%90th$45Professionalmedian $44 · 10th–90th $39–$1950%20%10th90th$44$50.0$100.0$200.0$500.0$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. 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
$38.90 / $41.69 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $60.26 / $630.96
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 / $30.20 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $141.25 / $177.83
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $58.88 / $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