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Wisconsin rates for HCPCS Q4106

Dermagraft, per sq cm

Facilitymedian $51 · 10th–90th $36–$1260%10%10th90th$51Professionalmedian $51 · 10th–90th $46–$1380%20%40%10th90th$51$50.0$100.0$200.0$500.0$1.0K

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
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $109.65 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $123.03 / $138.04
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $44.67 / $61.66
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $63.10 / $91.20
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $44.67 / $75.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $1,819.70
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $35.48 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $47.86 / $47.86
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $79.43
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $158.49
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $1,819.70 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $51.29 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $51.29 / $51.29