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Wisconsin rates for HCPCS Q4190

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

Facilitymedian $178 · 10th–90th $112$8320%20%10th90th$178Professionalmedian $123 · 10th–90th $112$9770%50%10th90th$123$5.0$20.0$100.0$500.0$2.0K

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
$114.82 / $114.82 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $123.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $724.44 / $1,548.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $489.78 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $199.53 / $223.87
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $114.82 / $251.19
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $131.83 / $831.76
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $1,096.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $58.88 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $467.74 / $467.74
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $245.47 / $398.11
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $302.00 / $933.25
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $831.76 / $1,047.13
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $125.89 / $1,122.02
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $177.83