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Nebraska rates for HCPCS Q4203

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

Facilitymedian $891 · 10th–90th $204–$1,5140%10%10th90th$891Professionalmedian $1,047 · 10th–90th $871–$1,1750%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
$128.82 / $1,047.13 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,047.13 / $1,230.27
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,122.02 / $1,202.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $346.74 / $1,047.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $1,047.13 / $1,659.59
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $870.96 / $1,047.13
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $363.08 / $1,047.13
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $309.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $1,000.00 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $363.08 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $141.25 / $302.00