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Kentucky rates for HCPCS Q4107

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

Facilitymedian $110 · 10th–90th $105–$1100%50%10th$110Professionalmedian $85 · 10th–90th $79–$1000%50%10th90th$85$20.0$50.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $83.18 / $85.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $109.65 / $109.65
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $93.33 / $93.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $162.18 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $125.89 / $457.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $158.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $125.89 / $134.90