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Indiana rates for HCPCS Q4111

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

Facilitymedian $209 · 10th–90th $8–$5130%10%10th90th$209Professionalmedian $7 · 10th–90th $7–$260%50%90th$7$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
$7.08 / $7.94 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $7.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $234.42 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $7.94 / $15.14
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.94 / $9.33 / $14.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.71 / $346.74 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $125.89 / $125.89