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Arizona rates for HCPCS Q4111

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

Facilitymedian $11 · 10th–90th $7–$1000%10%10th90th$11Professionalmedian $8 · 10th–90th $7–$1260%50%10th90th$8$5.0$10.0$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
$7.94 / $7.94 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $13.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.76 / $12.30 / $39.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $10.72 / $18.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $8.32 / $15.85
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $7.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $125.89 / $125.89