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Virginia rates for HCPCS Q4258

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

Facilitymedian $89 · 10th–90th $60–$1740%20%10th90th$89Professionalmedian $91 · 10th–90th $89–$1,6600%50%10th90th$91$2.0$10.0$50.0$200.0$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 / $89.13 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $1,659.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $2,344.23
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $239.88 / $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 / $173.78 / $1,513.56
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $97.72 / $707.95
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $660.69
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $72.44 / $120.23
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $72.44 / $120.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $117.49 / $1,513.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $125.89 / $134.90