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Restorigin

Montana 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?

$158

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $158 from a hospital or other facility.

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 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$158$126 to $1,072
FacilityA hospital or hospital-owned outpatient department$158$158 to $1,072

How much rates vary

Facilitymedian $158 · 10th to 90th $126 to $1,072Professionalmedian $158 · 10th to 90th $79 to $1,072
$100$200$500$1Kfacility $158professional $158

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$660.69
Median
$676.08
Typical High
$812.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$204.17
Median
$1,071.52
Typical High
$1,071.52
Cigna
Setting
Professional
Modifier
None
Typical Low
$1,071.52
Median
$1,071.52
Typical High
$1,071.52
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$125.89
Median
$158.49
Typical High
$208.93
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$141.25
Typical High
$158.49
Providence
Setting
Facility
Modifier
None
Typical Low
$204.17
Median
$1,071.52
Typical High
$1,071.52
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$1,071.52
Typical High
$1,071.52
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Montana 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.

Montana· 33rd of 51

$158

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.