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Restorigin

Ohio rates for HCPCS Q4191

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

Rates data updated July 2026.

Facilitymedian $417 · 10th–90th $102$7590%20%40%10th90th$417Professionalmedian $661 · 10th–90th $126$9770%50%10th90th$661$0.1$0.5$5.0$50.0$500.0$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
$660.69
Median
$660.69
Typical High
$758.58
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$724.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$707.95
Typical High
$1,230.27
CareSource
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
CareSource
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$891.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$269.15
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$181.97
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$269.15
Typical High
$389.05
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$912.01
Molina
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$60.26
Typical High
$724.44
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$38.02
Median
$141.25
Typical High
$158.49
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$144.54
Typical High
$2,137.96
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90