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Idaho rates for HCPCS Q4111

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

Facilitymedian $12 · 10th–90th $8–$1410%10%20%10th90th$12Professionalmedian $8 · 10th–90th $7–$1580%20%40%10th90th$8$10.0$20.0$50.0$100.0$200.0

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
$117.49 / $117.49 / $117.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $10.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.76 / $12.30 / $18.20
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $8.71 / $8.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.41 / $9.12 / $112.20
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $208.93 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.37 / $6.31 / $30.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $151.36
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $117.49 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.48 / $125.89 / $125.89