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Nebraska rates for HCPCS Q4101

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

Facilitymedian $34 · 10th–90th $30–$2090%20%40%10th90th$34Professionalmedian $30 · 10th–90th $30–$790%50%90th$30$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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 / $30.20 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $79.43
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $33.88 / $33.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $190.55 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $38.90 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $45.71 / $70.79
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $45.71
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $36.31 / $45.71
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $204.17 / $309.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $45.71 / $75.86
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $50.12 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $120.23 / $125.89