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Pennsylvania rates for HCPCS Q4113

GRAFTJACKET XPRESS, injectable, 1 cc

Facilitymedian $759 · 10th–90th $759–$2,8180%50%90th$759Professionalmedian $759 · 10th–90th $724–$1,3490%50%10th90th$759$1.0$10.0$100.0$1.0K$10.0K

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
$758.58 / $758.58 / $1,288.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $741.31 / $758.58
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,659.59 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,659.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $2,691.53 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $1,000.00
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $467.74
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $758.58
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $741.31 / $758.58
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $691.83 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,995.26 / $2,137.96