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Texas rates for HCPCS Q4174

PalinGen or ProMatrX, 0.36 mg per 0.25 cc

Facilitymedian $1,479 · 10th–90th $288–$3,9810%10%10th90th$1,479Professionalmedian $1,230 · 10th–90th $1,202–$1,2880%50%10th90th$1,230$20.0$100.0$500.0$2.0K$10.0K

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 / $1,230.27 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,230.27 / $1,288.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $2,041.74 / $3,890.45
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $2,951.21 / $8,511.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $4,466.84
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,760.83 / $6,760.83 / $6,760.83
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $1,230.27 / $2,137.96
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,230.27 / $1,412.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $288.40 / $288.40
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $1,258.93 / $2,570.40
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,398.83 / $2,398.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,258.93