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Nebraska rates for HCPCS Q4219

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

Facilitymedian $955 · 10th–90th $191–$1,8200%10%10th90th$955Professionalmedian $977 · 10th–90th $871–$1,2020%20%40%10th90th$977$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $954.99 / $954.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $977.24 / $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 / $147.91 / $181.97
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,202.26 / $1,862.09
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $870.96
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $954.99 / $2,089.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $141.25 / $794.33