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Virginia rates for HCPCS Q4180

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

Facilitymedian $331 · 10th–90th $166–$1,2300%20%10th90th$331Professionalmedian $661 · 10th–90th $135–$1,6600%50%10th90th$661$2.0$10.0$50.0$200.0$1.0K$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
$660.69 / $660.69 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,659.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $2,344.23
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $173.78 / $1,513.56
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $691.83 / $1,659.59
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $660.69 / $660.69
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $199.53 / $933.25
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $199.53 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,698.24 / $2,238.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,023.29