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North Carolina rates for HCPCS Q4219

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

Facilitymedian $158 · 10th–90th $100–$1,4450%20%10th90th$158Professionalmedian $955 · 10th–90th $89–$1,0230%20%10th90th$955$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$100.00 / $100.00 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $1,000.00 / $1,023.29
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $131.83 / $208.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $169.82
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $954.99 / $1,412.54
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $316.23
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $194.98 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $954.99 / $1,445.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $794.33
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $5,370.32