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Michigan rates for HCPCS Q4101

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

Facilitymedian $89 · 10th–90th $31–$44,6680%10%20%10th90th$89Professionalmedian $30 · 10th–90th $30–$780%50%90th$30$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$30.90 / $89.13 / $44,668.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $41.69
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $30.90 / $30.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $30.90 / $30.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $125.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $57.54 / $169.82
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $57.54 / $138.04
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $125.89
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