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Restorigin

Maine rates for HCPCS Q4191

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

Rates data updated October 2026.

How much does Restorigin cost?

$126

Typical negotiated rate. In Maine, October 2026.

Insurers have agreed to pay about $126 for this service. Most negotiated rates run $126 to $661.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $145 · 10th to 90th $145 to $363Professionalmedian $126 · 10th to 90th $107 to $676
$100$200$500facility $145professional $126

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$95.50
Median
$125.89
Typical High
$245.47
Cigna
Setting
Facility
Modifier
None
Typical Low
$144.54
Median
$144.54
Typical High
$363.08
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$223.87
Typical High
$660.69
Martin's Point
Setting
Professional
Modifier
None
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
Martin's Point
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Martin's Point
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Martin's Point
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$102.33
Median
$102.33
Typical High
$102.33
Martin's Point
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$67.61
Median
$67.61
Typical High
$67.61
United
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$125.89
Typical High
$190.55

Where Maine sits

The same service costs 12.6 times more in Wyoming than in North Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Maine· 41st of 51

$126

WY $1,479NC $117

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.