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Idaho rates for HCPCS Q4101

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

Facilitymedian $52 · 10th–90th $30–$1410%10%10th90th$52Professionalmedian $33 · 10th–90th $30–$1620%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
$117.49 / $117.49 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $56.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$37.15 / $64.57 / $91.20
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $323.59
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 / $38.02 / $93.33
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $208.93 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $26.30 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $151.36
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $117.49 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $125.89 / $125.89