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Montana rates for HCPCS Q4201

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

Facilitymedian $182 · 10th–90th $83–$2140%50%10th90th$182Professionalmedian $79 · 10th–90th $76–$1820%20%40%10th90th$79$100.0$200.0$500.0

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
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $181.97
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $213.80
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $213.80
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $97.72 / $281.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $97.72 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89