HCPCS 52544008430 Prescription Drug - Brand

How Much Does Gelnique 10% Gel Sachets Cost?

Also known as: GELNIQUE 10% GEL SACHETS (CPT 52544008430)

Gelnique 10% Gel Sachets (CPT 52544008430) costs $13 at Medicare rates.

The rates shown below represent the complete Medicare reimbursement for this service. No separate facility fee applies for this type of procedure.

Medicare (Facility)
$13
CMS PFS 2026 national rate

Procedures Commonly Done Together

These procedures are frequently performed alongside GELNIQUE 10% GEL SACHETS

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How to Reduce Your Cost for GELNIQUE 10% GEL SACHETS

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

Frequently Asked Questions

How much does GELNIQUE 10% GEL SACHETS cost?

The Medicare facility rate for GELNIQUE 10% GEL SACHETS is $13. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does GELNIQUE 10% GEL SACHETS cost without insurance?

Without insurance, the cost of GELNIQUE 10% GEL SACHETS can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover GELNIQUE 10% GEL SACHETS?

Most commercial health insurance plans and Medicare cover GELNIQUE 10% GEL SACHETS when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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