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Maryland rates for HCPCS Q4115

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

Facilitymedian $7 · 10th–90th $7–$120%20%40%90th$7Professionalmedian $12 · 10th–90th $12–$1260%50%90th$12$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.85
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $8.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.24 / $7.24 / $7.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $151.36 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $125.89 / $128.82
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $158.49 / $204.17