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North Carolina rates for HCPCS Q4115

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

Facilitymedian $16 · 10th–90th $10$1910%10%20%10th90th$16Professionalmedian $13 · 10th–90th $12$1100%20%10th90th$13$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
$15.85 / $15.85 / $15.85
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
$8.32 / $9.12 / $9.77
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $95.50
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $125.89 / $125.89
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $10.00
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.48 / $16.22 / $26.30
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $316.23
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $194.98 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $20.42 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $125.89 / $125.89
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69