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Missouri rates for HCPCS Q4116

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

Facilitymedian $12,303 · 10th–90th $25–$33,1130%20%10th90th$12,303Professionalmedian $26 · 10th–90th $24–$1350%20%10th90th$26$10.0$50.0$200.0$1.0K$5.0K$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
$25.12 / $12,302.69 / $33,113.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $25.12 / $117.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $109.65 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $144.54 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $223.87 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $30.90 / $89.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $30.90 / $38.02
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