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Utah rates for HCPCS Q4184

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

Facilitymedian $91 · 10th–90th $91–$1200%50%90th$91Professionalmedian $87 · 10th–90th $79–$3020%50%10th90th$87$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $114.82 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $141.25 / $162.18
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $120.23 / $125.89
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $169.82 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89