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Arizona rates for HCPCS Q4101

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

Facilitymedian $52 · 10th–90th $30–$2510%10%10th90th$52Professionalmedian $30 · 10th–90th $30–$1260%50%90th$30$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
$52.48 / $56.23 / $3,801.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $120.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $48.98 / $158.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $42.66 / $75.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $36.31 / $67.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $52.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $125.89 / $125.89