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Washington, DC rates for HCPCS Q4116

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.44 / $28,737.08 / $43,398.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.44 / $26.44 / $26.44
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.32 / $34.32 / $34.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.11 / $31.11 / $31.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.11 / $31.11 / $39.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.00 / $32.00 / $32.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.11 / $31.11 / $50.42