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Novafix DL

Montana rates for HCPCS Q4254

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

Rates data updated July 2026.

Facilitymedian $355 · 10th–90th $138$4790%20%10th90th$355Professionalmedian $126 · 10th–90th $98$4170%20%10th90th$126$50.0$100.0$200.0$500.0

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
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$128.82
Typical High
$416.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$204.17
Typical High
$407.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$407.38
Providence
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$354.81
Typical High
$478.63
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$389.05
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89