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Montana rates for HCPCS Q4225

AmnioBind or DermaBind TL, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $1,479 · 10th–90th $170–$1,8200%20%10th90th$1,479Professionalmedian $1,413 · 10th–90th $126–$1,6600%50%10th90th$1,413$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
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,659.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $1,584.89 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $1,584.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $1,445.44 / $1,819.70
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $1,584.89 / $2,454.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89