go back

Washington rates for HCPCS Q4111

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

Facilitymedian $14 · 10th–90th $7$3390%10%10th90th$14Professionalmedian $8 · 10th–90th $7$1260%20%40%10th90th$8$5.0$20.0$100.0$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 / $281.84 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $14.13
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $125.89 / $125.89
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $169.82 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.71 / $16.60 / $380.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $14.79 / $20.42
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $33.11 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $7.94 / $8.13
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.46 / $7.59 / $10.96
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $7.59 / $7.76
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.92 / $7.59 / $125.89
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $125.89 / $141.25
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
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $154.88 / $295.12