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Restorigin

North Carolina rates for HCPCS Q4191

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

Rates data updated July 2026.

Facilitymedian $490 · 10th–90th $158$1,9050%20%10th90th$490Professionalmedian $417 · 10th–90th $89$6920%20%10th90th$417$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
$416.87
Median
$416.87
Typical High
$416.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$660.69
Typical High
$691.83
BCBS
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$144.54
Typical High
$151.36
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$117.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$190.55
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$181.97
Medcost
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$660.69
Typical High
$1,905.46
Medcost
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$208.93
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$147.91
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$3,981.07
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$3,467.37
Median
$3,467.37
Typical High
$3,630.78