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Alaska rates for HCPCS Q4191

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

Facilitymedian $813 · 10th–90th $178–$1,9050%20%10th90th$813Professionalmedian $661 · 10th–90th $229–$8130%50%10th90th$661$100.0$200.0$500.0$1.0K$2.0K$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
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $676.08 / $1,737.80
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $338.84 / $954.99
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $2,454.71 / $3,890.45
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,905.46 / $2,089.30
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $676.08 / $1,737.80
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $125.89 / $1,258.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $446.68