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Apligraf

Utah rates for HCPCS Q4101

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

Rates data updated July 2026.

How much does Apligraf cost?

$34.67

Typical negotiated rate. In Utah, July 2026.

Insurers have agreed to pay about $34.67 for this service. The price depends on where it is billed: about $33.11 from a physician practice, and about $45.71 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$33.11$30.20 to $126
FacilityA hospital or hospital-owned outpatient department$45.71$34.67 to $74.13

How much rates vary

Facilitymedian $46 · 10th to 90th $35 to $74Professionalmedian $33 · 10th to 90th $30 to $135
$50$100$200$500facility $46professional $33

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$74.13
Typical High
$74.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$33.11
Typical High
$38.02
Cigna
Setting
Facility
Modifier
Global
Typical Low
$35.48
Median
$43.65
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Molina
Setting
Professional
Modifier
Global
Typical Low
$21.38
Median
$30.20
Typical High
$60.26
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$131.83
Typical High
$162.18
Select Health
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Select Health
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$120.23
Typical High
$144.54
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$169.82
Typical High
$269.15
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89

Where Utah sits

The same service costs 3.9 times more in Oregon than in Colorado. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Utah· 14th of 51

$34.67

OR $117CO $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.