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Maryland rates for HCPCS Q4219

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

Facilitymedian $794 · 10th–90th $794–$7940%50%100%$794Professionalmedian $1,000 · 10th–90th $126–$1,0230%20%40%10th90th$1,000$100.0$200.0$500.0$1.0K$2.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,000.00 / $1,023.29
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $144.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $181.97 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $794.33
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $181.97 / $204.17