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Virginia rates for HCPCS Q4191

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

Facilitymedian $1,514 · 10th–90th $661–$2,5700%20%10th90th$1,514Professionalmedian $661 · 10th–90th $407–$1,7380%50%10th90th$661$2.0$10.0$50.0$200.0$1.0K$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,737.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $2,454.71
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $173.78 / $1,584.89
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $691.83 / $1,737.80
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $660.69 / $1,659.59
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,584.89 / $3,467.37
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,584.89 / $3,548.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $2,041.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $933.25