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Washington, DC rates for HCPCS Q4107

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

Facilitymedian $85 · 10th–90th $85–$2630%50%90th$85Professionalmedian $85 · 10th–90th $79–$1200%50%10th90th$85$100.0$200.0$500.0

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $83.18 / $100.00
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $263.03 / $446.68
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
$114.82 / $123.03 / $162.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $158.49