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Missouri rates for HCPCS Q4191

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

Facilitymedian $794 · 10th–90th $129–$1,8200%10%10th90th$794Professionalmedian $661 · 10th–90th $110–$7940%20%40%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
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $676.08 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $794.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $1,621.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $144.54 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $239.88 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,023.29 / $2,089.30
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $724.44 / $5,754.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $1,258.93 / $1,380.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $125.89 / $933.25