go back

Texas rates for HCPCS Q4115

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

Facilitymedian $20 · 10th–90th $12$3980%20%10th90th$20Professionalmedian $13 · 10th–90th $12$1260%20%40%10th90th$13$2.0$10.0$50.0$200.0$1.0K

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 / $15.49
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $33.88 / $66.07
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $120.23 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $302.00 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $138.04
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $14.13 / $218.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $14.13 / $32.36
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $15.14 / $16.22
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $13.18 / $165.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
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
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $125.89 / $125.89