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Michigan rates for HCPCS Q4201

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

Facilitymedian $102 · 10th–90th $78–$3800%20%40%10th90th$102Professionalmedian $76 · 10th–90th $76–$1620%50%90th$76$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
$77.62 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $125.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $354.81 / $954.99
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $138.04 / $457.09
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $125.89 / $125.89