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Missouri rates for HCPCS Q4199

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

Facilitymedian $200 · 10th–90th $112–$5010%10%10th90th$200Professionalmedian $112 · 10th–90th $110–$1510%50%10th90th$112$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $114.82 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $131.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $109.65 / $138.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $144.54 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $239.88 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $181.97 / $478.63
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $128.82 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $446.68 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $125.89 / $331.13