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Montana rates for HCPCS Q4173

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

Facilitymedian $417 · 10th–90th $347–$7410%20%40%10th90th$417Professionalmedian $347 · 10th–90th $158–$4370%20%40%10th90th$347$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
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $416.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $407.38 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $407.38
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $741.31
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $741.31
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $380.19 / $676.08
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89