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Pennsylvania rates for HCPCS Q4191

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

Facilitymedian $661 · 10th–90th $214–$1,4450%50%10th90th$661Professionalmedian $661 · 10th–90th $174–$7590%50%10th90th$661$1.0$10.0$100.0$1.0K$10.0K

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 / $660.69 / $660.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $724.44
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,445.44 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $446.68 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $263.03 / $1,479.11
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $151.36 / $213.80
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $691.83
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $229.09 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $933.25