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Oregon rates for HCPCS Q4199

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

Facilitymedian $117 · 10th–90th $112–$2290%50%10th90th$117Professionalmedian $126 · 10th–90th $112–$3390%20%40%10th90th$126$100.0$500.0$2.0K$10.0K$50.0K$200.0K$1.0M

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 / $117.49 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $165.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $512.86 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $151.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $263.03 / $323.59
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $141.25 / $354.81
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $251.19 / $354.81
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $165.96
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $138.04 / $512.86
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $575.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89