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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
$25.70 / $28,840.32 / $40,738.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $25.70 / $30.90
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $34.67 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $30.90 / $30.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $30.90 / $35.48
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $151.36 / $186.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.90 / $30.90 / $30.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $50.12 / $125.89