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Michigan rates for HCPCS Q4111

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

Facilitymedian $8 · 10th–90th $8–$1020%50%10th90th$8Professionalmedian $7 · 10th–90th $7–$110%50%90th$7$2.0$5.0$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
$7.94 / $7.94 / $7.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $8.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $7.08 / $7.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.47 / $7.08 / $7.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $125.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.94 / $11.75 / $22.91
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.94 / $138.04
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $125.89 / $125.89