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Ohio rates for HCPCS Q4174

PalinGen or ProMatrX, 0.36 mg per 0.25 cc

Facilitymedian $1,202 · 10th–90th $1,202–$3,0900%50%90th$1,202Professionalmedian $1,230 · 10th–90th $288–$1,2590%20%10th90th$1,230$20.0$50.0$100.0$200.0$500.0$1.0K$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
$1,202.26 / $1,202.26 / $1,202.26
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 / $363.08 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,162.28 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $346.74 / $478.63
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $1,513.56 / $2,630.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $3,090.30 / $3,090.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,258.93 / $1,288.25