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Arizona rates for HCPCS Q4115

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

Facilitymedian $22 · 10th–90th $12–$830%10%20%10th90th$22Professionalmedian $13 · 10th–90th $12–$1260%20%40%10th90th$13$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
$22.39 / $22.39 / $23.99
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $21.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.22 / $19.95 / $64.57
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $17.38 / $30.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $16.22 / $25.12
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $14.45
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $125.89 / $125.89