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Minnesota rates for HCPCS Q4115

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

Facilitymedian $23 · 10th–90th $12–$470%20%10th90th$23Professionalmedian $102 · 10th–90th $10–$1260%20%10th90th$102$0.2$1.0$5.0$20.0$100.0$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 / $12.02 / $12.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $15.85
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $22.91 / $25.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $107.15 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $39.81 / $56.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $14.79 / $15.85
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $37.15 / $46.77
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $14.45
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $30.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $14.45 / $19.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $125.89 / $239.88