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Missouri rates for HCPCS Q4101

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

Facilitymedian $85 · 10th–90th $30–$2,6920%10%20%10th90th$85Professionalmedian $33 · 10th–90th $30–$1410%20%40%10th90th$33$20.0$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
$30.20 / $870.96 / $2,691.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $134.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $97.72 / $131.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $144.54 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $223.87 / $302.00
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 / $44.67 / $87.10
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $30.20 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $43.65 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $125.89 / $125.89