go back

Missouri rates for HCPCS Q4115

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

Facilitymedian $17 · 10th–90th $13–$1450%20%10th90th$17Professionalmedian $13 · 10th–90th $12–$1260%20%10th90th$13$5.0$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. 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
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $109.65 / $131.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $144.54 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $223.87 / $302.00
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
$13.18 / $17.38 / $43.65
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $14.45 / $67.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.60 / $18.20 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $125.89 / $125.89