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Michigan rates for HCPCS Q4258

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

Facilitymedian $91 · 10th–90th $91–$1,9050%50%90th$91Professionalmedian $89 · 10th–90th $89–$1260%50%90th$89$100.0$200.0$500.0$1.0K$2.0K$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
$91.20 / $91.20 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $125.89 / $125.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,905.46 / $5,128.61
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $123.03 / $2,187.76
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $125.89 / $125.89