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Montana rates for HCPCS Q4234

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

Facilitymedian $1,096 · 10th–90th $282–$1,2300%20%10th90th$1,096Professionalmedian $550 · 10th–90th $158–$8510%20%40%10th90th$550$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$549.54 / $549.54 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $281.84 / $281.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $281.84
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,122.02 / $1,584.89
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,122.02 / $1,584.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $549.54 / $1,071.52
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89