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Missouri rates for HCPCS Q4203

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

Facilitymedian $955 · 10th–90th $126$1,3180%20%10th90th$955Professionalmedian $1,047 · 10th–90th $110$1,1480%20%40%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
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,096.48
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,230.27
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$109.65
Typical High
$144.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$144.54
Typical High
$181.97
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$239.88
Typical High
$371.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$151.36
Medica
Setting
Facility
Modifier
Global
Typical Low
$851.14
Median
$1,023.29
Typical High
$2,041.74
Medica
Setting
Professional
Modifier
Global
Typical Low
$741.31
Median
$870.96
Typical High
$1,318.26
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$398.11
Typical High
$436.52
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$125.89
Typical High
$302.00