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Missouri rates for HCPCS Q4174

PalinGen or ProMatrX, 0.36 mg per 0.25 cc

Facilitymedian $1,585 · 10th–90th $1,202–$2,3990%20%10th90th$1,585Professionalmedian $1,230 · 10th–90th $1,202–$1,2590%50%10th90th$1,230$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
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,584.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,230.27 / $1,258.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $1,258.93 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,089.30 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,479.11 / $3,235.94
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,258.93 / $5,623.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,290.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,258.93 / $1,348.96