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Utah rates for HCPCS Q4187

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

Facilitymedian $282 · 10th–90th $282–$8910%50%90th$282Professionalmedian $245 · 10th–90th $126–$3090%20%40%10th90th$245$50.0$100.0$200.0$500.0$1.0K

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
$281.84 / $281.84 / $891.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $245.47 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $323.59 / $446.68
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 / $186.21 / $251.19
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
$120.23 / $120.23 / $128.82
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $177.83 / $269.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $134.90