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Alaska rates for HCPCS Q4203

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

Facilitymedian $1,096 · 10th–90th $178$2,1380%20%10th90th$1,096Professionalmedian $1,047 · 10th–90th $229$1,2020%50%10th90th$1,047$100.0$200.0$500.0$1.0K$2.0K

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
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,230.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$1,096.48
Typical High
$1,949.84
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$316.23
Typical High
$741.31
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$1,412.54
Typical High
$2,187.76
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,096.48
Typical High
$1,202.26
Providence
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$1,096.48
Typical High
$1,949.84
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$125.89
Typical High
$371.54
United
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$125.89
Typical High
$354.81