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Virginia rates for HCPCS Q4219

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

Facilitymedian $214 · 10th–90th $126–$1,2880%20%10th90th$214Professionalmedian $977 · 10th–90th $126–$1,2020%20%40%10th90th$977$2.0$10.0$50.0$200.0$1.0K$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
$1,023.29 / $1,023.29 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,000.00 / $1,202.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $954.99 / $1,819.70
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $173.78 / $707.95
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $1,122.02 / $1,621.81
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $1,202.26 / $1,202.26
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $138.04 / $524.81
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $138.04 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,288.25 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $794.33