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Alaska rates for HCPCS Q4101

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

Facilitymedian $48 · 10th–90th $30–$1780%10%10th90th$48Professionalmedian $33 · 10th–90th $30–$2950%20%40%10th90th$33$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$56.23 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $165.96
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $288.40 / $489.78
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $104.71 / $186.21
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $60.26 / $64.57
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $44.67 / $144.54
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $60.26 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $125.89 / $354.81