go back

Virginia rates for HCPCS Q4203

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

Facilitymedian $219 · 10th–90th $126$1,2590%20%10th90th$219Professionalmedian $1,047 · 10th–90th $126$1,0960%50%10th90th$1,047$2.0$10.0$50.0$200.0$1.0K$5.0K

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 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,047.13 / $1,096.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,412.54
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $173.78 / $891.25
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $1,047.13 / $1,778.28
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $1,000.00 / $1,000.00
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $138.04 / $524.81
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $138.04 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $851.14
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $302.00