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California rates for HCPCS Q4116

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

Facilitymedian $40 · 10th–90th $31$9,1200%20%10th90th$40Professionalmedian $31 · 10th–90th $24$1740%20%40%10th90th$31$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$2,754.23 / $19,952.62 / $67,608.30
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $25.12 / $85.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $38.90 / $97.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $38.90 / $151.36
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $58.88 / $87.10
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $44.67 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $218.78 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $177.83 / $239.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $169.82 / $269.15
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
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $33.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $32.36 / $204.17
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $38.90 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $125.89 / $173.78