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Virginia rates for HCPCS Q4254

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

Facilitymedian $166 · 10th–90th $117–$4900%20%10th90th$166Professionalmedian $355 · 10th–90th $115–$4790%20%40%10th90th$355$2.0$10.0$50.0$200.0$1.0K$5.0K

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
$134.90 / $134.90 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $354.81 / $380.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $151.36 / $239.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $354.81 / $524.81
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $354.81 / $457.09
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $151.36 / $524.81
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $151.36 / $524.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $436.52 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $478.63