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Alaska rates for HCPCS Q4115

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

Facilitymedian $16 · 10th–90th $11–$1450%20%10th90th$16Professionalmedian $13 · 10th–90th $12–$3020%20%40%10th90th$13$10.0$50.0$200.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $25.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
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
$11.48 / $14.13 / $33.88
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.85 / $302.00 / $512.86
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.88 / $24.55 / $3,467.37
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $15.14 / $15.14
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.48 / $15.49 / $144.54
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $60.26 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $107.15 / $316.23