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California rates for HCPCS Q4101

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

Facilitymedian $59 · 10th–90th $47$2690%50%10th90th$59Professionalmedian $41 · 10th–90th $30$1580%20%40%10th90th$41$0.1$2.0$50.0$1.0K$20.0K$500.0K

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
$30.20 / $2,041.74 / $5,888.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $134.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $58.88 / $147.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $48.98 / $89.13
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $69.18 / $97.72
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $48.98 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $218.78 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $177.83 / $239.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $165.96 / $269.15
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $33.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $41.69 / $194.98
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $125.89 / $125.89
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $45.71 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $125.89 / $151.36