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Wisconsin rates for HCPCS Q4173

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

Facilitymedian $363 · 10th–90th $347–$9550%20%40%10th90th$363Professionalmedian $355 · 10th–90th $200–$8510%50%10th90th$355$5.0$20.0$100.0$500.0$2.0K

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
$363.08 / $363.08 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $380.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $630.96 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $707.95 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $223.87 / $457.09
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $363.08 / $794.33
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $363.08 / $794.33
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $1,148.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $58.88 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $407.38
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $302.00 / $831.76
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $691.83 / $2,454.71
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $398.11 / $2,818.38
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $851.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $363.08