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Illinois rates for HCPCS Q4191

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

Facilitymedian $219 · 10th–90th $151–$6610%10%20%10th90th$219Professionalmedian $661 · 10th–90th $407–$1,0720%50%10th90th$661$50.0$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
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $660.69 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $724.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $281.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $239.88 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $977.24
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $912.01 / $2,089.30
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $39.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $1,548.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $933.25