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Washington rates for HCPCS Q4106

Dermagraft, per sq cm

Facilitymedian $41 · 10th–90th $33–$710%10%20%10th90th$41Professionalmedian $51 · 10th–90th $45–$510%50%10th$51$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $41.69 / $56.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.11 / $51.29 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $51.29