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New York rates for HCPCS Q4107

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

Facilitymedian $105 · 10th–90th $79$1780%20%40%10th90th$105Professionalmedian $95 · 10th–90th $81$1260%50%10th90th$95$50.0$200.0$1.0K$5.0K$20.0K

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
$69.18 / $120.23 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $83.18 / $100.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $162.18 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $181.97
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $158.49 / $416.87
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $204.17
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $100.00 / $138.04
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $97.72
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11