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Montana rates for HCPCS Q4176

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

Facilitymedian $162 · 10th–90th $76–$2040%20%10th90th$162Professionalmedian $155 · 10th–90th $126–$1620%20%40%10th90th$155$100.0$200.0

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
$151.36 / $158.49 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $144.54 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $125.89 / $181.97
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $162.18
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $162.18
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $169.82 / $257.04
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $85.11 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89