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Restorigin

Washington rates for HCPCS Q4191

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

Rates data updated July 2026.

Facilitymedian $724 · 10th–90th $347$3,4670%10%20%10th90th$724Professionalmedian $661 · 10th–90th $126$1,0960%20%10th90th$661$50.0$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
$724.44
Median
$724.44
Typical High
$724.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$812.83
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$141.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$131.83
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$1,479.11
Typical High
$4,073.80
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$2,454.71
Median
$3,467.37
Typical High
$4,466.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$50.12
Typical High
$60.26
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$1,348.96
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$1,445.44
Typical High
$1,445.44
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$1,096.48
Typical High
$1,096.48
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$128.82
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$154.88
Typical High
$1,023.29