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South Carolina rates for HCPCS Q4219

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

Facilitymedian $977 · 10th–90th $145–$1,3180%10%20%10th90th$977Professionalmedian $977 · 10th–90th $100–$1,0230%20%40%10th90th$977$50.0$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
$977.24 / $977.24 / $977.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $1,000.00 / $1,023.29
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $117.49 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $1,047.13 / $1,548.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $85.11 / $812.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $1,288.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $125.89 / $794.33