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Utah rates for HCPCS Q4194

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

Facilitymedian $776 · 10th–90th $776–$1,0000%50%90th$776Professionalmedian $661 · 10th–90th $126–$8320%20%40%10th90th$661$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $776.25 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $676.08 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $870.96 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $141.25 / $162.18
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $125.89
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $177.83 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $134.90