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Virginia rates for HCPCS Q4101

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

Facilitymedian $37 · 10th–90th $30–$2140%20%10th90th$37Professionalmedian $31 · 10th–90th $30–$1260%50%10th90th$31$2.0$10.0$50.0$200.0$1.0K$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 / $37.15 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $54.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $77.62
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $46.77
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $173.78 / $3,890.45
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $31.62
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $34.67 / $60.26
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $109.65
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $36.31 / $51.29
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $36.31 / $51.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $64.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $125.89 / $125.89