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Pennsylvania rates for HCPCS Q4101

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

Facilitymedian $126 · 10th–90th $30–$7,7620%20%10th90th$126Professionalmedian $30 · 10th–90th $30–$1260%50%90th$30$1.0$10.0$100.0$1.0K$10.0K

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 / $1,202.26 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $50.12
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $44.67 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $44.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $446.68 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $3,630.78 / $3,630.78
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $131.83 / $199.53
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $316.23
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $33.88
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $54.95
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $79.43 / $245.47
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $35.48 / $35.48
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $33.11 / $35.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $125.89 / $134.90