go back

Wisconsin rates for HCPCS Q4115

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

Facilitymedian $15 · 10th–90th $12$1000%20%40%10th90th$15Professionalmedian $13 · 10th–90th $12$1260%20%10th90th$13$5.0$20.0$100.0$500.0$2.0K

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
$12.88 / $12.88 / $12.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $14.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $17.38 / $33.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $34.67 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $33.11 / $125.89
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $13.18 / $28.18
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $16.60 / $17.78
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.45 / $14.79 / $75.86
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $14.45 / $21.88
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $12.88 / $15.85
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $16.22 / $25.70
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $245.47 / $416.87
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $85.11 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $14.45 / $67.61
Security Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $380.19
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $17.38 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $28.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $125.89 / $134.90