go back

Massachusetts rates for HCPCS Q4191

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

Facilitymedian $661 · 10th–90th $151–$3,9810%50%10th90th$661Professionalmedian $661 · 10th–90th $214–$7590%50%10th90th$661$100.0$500.0$2.0K$10.0K$50.0K

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
$660.69 / $660.69 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $758.58
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $269.15 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $177.83 / $6,918.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,737.80 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $660.69 / $977.24