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Idaho rates for HCPCS Q4116

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

Facilitymedian $79 · 10th–90th $28–$19,9530%10%20%10th90th$79Professionalmedian $26 · 10th–90th $24–$1660%20%40%10th90th$26$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$38.02 / $19,952.62 / $19,952.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $25.12 / $37.15
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $60.26 / $97.72
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $151.36 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $30.90 / $123.03
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $218.78 / $251.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $77.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $151.36
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $117.49 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $125.89 / $125.89