go back

Minnesota rates for HCPCS Q4203

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

Facilitymedian $447 · 10th–90th $302–$1,0470%20%10th90th$447Professionalmedian $126 · 10th–90th $107–$1,0470%20%10th90th$126$0.2$1.0$5.0$20.0$100.0$500.0$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
$1,047.13 / $1,047.13 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,047.13 / $1,148.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $446.68 / $478.63
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $125.89 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $891.25 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $338.84 / $389.05
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $912.01 / $1,148.15
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $380.19
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $1,479.11
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$741.31 / $870.96 / $1,148.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $371.54