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Novafix DL

Ohio rates for HCPCS Q4254

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

Rates data updated July 2026.

Facilitymedian $115 · 10th–90th $65$3720%20%10th90th$115Professionalmedian $355 · 10th–90th $115$5010%20%40%10th90th$355$2.0$10.0$50.0$200.0$1.0K

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
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$114.82
Aetna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$354.81
Typical High
$389.05
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$380.19
Typical High
$602.56
Cigna
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$269.15
Typical High
$416.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$181.97
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$269.15
Typical High
$389.05
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$354.81
Molina
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$165.96
Typical High
$707.95
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$141.25
Typical High
$158.49
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$144.54
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$165.96