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Wisconsin rates for HCPCS Q4251

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

Facilitymedian $182 · 10th–90th $145–$3890%20%40%10th90th$182Professionalmedian $148 · 10th–90th $145–$2880%50%10th90th$148$5.0$20.0$100.0$500.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $147.91 / $151.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $251.19 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $199.53 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $147.91 / $181.97
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $151.36 / $218.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $169.82 / $363.08
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $691.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $58.88 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $275.42 / $446.68
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $537.03
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $812.83
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $190.55 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $181.97