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Illinois rates for HCPCS Q4116

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

Facilitymedian $1,995 · 10th–90th $35–$58,8840%5%10%10th90th$1,995Professionalmedian $26 · 10th–90th $24–$1170%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
$34.67 / $7,244.36 / $60,255.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $25.12 / $39.81
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $208.93 / $316.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $33.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $36.31 / $158.49
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $125.89 / $125.89