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Illinois rates for HCPCS Q4258

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

Facilitymedian $195 · 10th–90th $89–$3020%10%20%10th90th$195Professionalmedian $89 · 10th–90th $89–$1260%50%90th$89$50.0$100.0$200.0$500.0$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $117.49 / $1,737.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $107.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $131.83
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $102.33 / $165.96
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $125.89 / $131.83