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Derma-Gide

Montana rates for HCPCS Q4203

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

Rates data updated July 2026.

How much does Derma-Gide cost?

$912

Typical negotiated rate. In Montana, July 2026.

Insurers have agreed to pay about $912 for this service. The price depends on where it is billed: about $1,047 from a physician practice, and about $316 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,047$316 to $1,148
FacilityA hospital or hospital-owned outpatient department$316$302 to $407

How much rates vary

Facilitymedian $316 · 10th to 90th $234 to $1,047Professionalmedian $1,047 · 10th to 90th $126 to $1,148
$100$200$500$1Kfacility $316professional $1,047

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$1,096.48
Typical High
$1,230.27
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$204.17
Typical High
$338.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$323.59
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$316.23
Typical High
$407.38
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$316.23
Typical High
$407.38
Providence
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$1,047.13
Typical High
$1,318.26
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$371.54
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Montana sits

The same service costs 5.0 times more in California than in Minnesota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 45th of 51

$912

CA $1,072MN $214

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.