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Hawaii rates for HCPCS Q4203

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

Professionalmedian $1,047 · 10th–90th $275–$1,0960%50%10th90th$1,047$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
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $1,047.13 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $295.12 / $380.19
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $436.52 / $457.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $173.78 / $218.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $309.03