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Alaska rates for HCPCS Q4258

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

Facilitymedian $145 · 10th–90th $89–$1,8200%20%10th90th$145Professionalmedian $91 · 10th–90th $89–$3390%50%10th90th$91$100.0$200.0$500.0$1.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $134.90 / $363.08
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $302.00 / $512.86
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $2,344.23 / $3,630.78
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,819.70 / $1,995.26
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $141.25 / $363.08
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $91.20 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $323.59