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Oregon rates for HCPCS Q4191

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

Facilitymedian $661 · 10th–90th $661–$1,0230%50%90th$661Professionalmedian $661 · 10th–90th $126–$7590%20%40%10th90th$661$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

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
$117.49 / $117.49 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $758.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $1,445.44 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $151.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $323.59
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $660.69 / $1,202.26
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $251.19 / $660.69
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $812.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $724.44 / $1,819.70
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $1,584.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89