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Nebraska rates for HCPCS Q4258

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

Facilitymedian $138 · 10th–90th $83–$2,8180%10%10th90th$138Professionalmedian $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
$89.13 / $89.13 / $128.82
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
$87.10 / $102.33 / $4,265.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $100.00 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $120.23 / $165.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $83.18 / $123.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $87.10 / $109.65
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $309.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $109.65 / $204.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $102.33 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $125.89 / $141.25