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Restorigin

Indiana rates for HCPCS Q4191

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

Rates data updated July 2026.

Facilitymedian $380 · 10th–90th $141$6610%10%10th90th$380Professionalmedian $661 · 10th–90th $126$7410%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
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$676.08
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$380.19
Typical High
$512.86
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$562.34
Median
$660.69
Typical High
$1,023.29
CareSource
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$794.33
Typical High
$1,174.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$346.74
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$162.18
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$257.04
Typical High
$257.04
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$138.04