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Massachusetts rates for HCPCS Q4254

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

Facilitymedian $355 · 10th–90th $141–$1,0720%50%10th90th$355Professionalmedian $355 · 10th–90th $117–$3890%50%10th90th$355$50.0$200.0$1.0K$5.0K$20.0K

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
$354.81 / $354.81 / $354.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $354.81 / $389.05
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $269.15 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $177.83 / $6,918.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,071.52
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $354.81 / $478.63