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Indiana rates for HCPCS Q4115

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

Facilitymedian $209 · 10th–90th $13–$5130%10%10th90th$209Professionalmedian $13 · 10th–90th $12–$430%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
$12.02 / $12.88 / $12.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.85
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $234.42 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $24.55
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $15.49 / $22.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $346.74 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $125.89 / $125.89