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Arizona rates for HCPCS Q4203

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

Facilitymedian $589 · 10th–90th $240–$1,5140%5%10th90th$589Professionalmedian $1,047 · 10th–90th $135–$1,1480%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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,047.13 / $1,148.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $478.63 / $1,548.82
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $426.58 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $977.24 / $1,659.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $1,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $489.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $302.00