go back

Washington, DC rates for HCPCS Q4205

Membrane Graft or Membrane Wrap, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $1,230 · 10th–90th $195–$1,2300%50%10th$1,230Professionalmedian $1,230 · 10th–90th $1,230–$1,2880%50%90th$1,230$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,288.25
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $1,621.81 / $3,162.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $263.03 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $162.18
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $1,412.54 / $1,513.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $1,047.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,258.93