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Nebraska rates for HCPCS Q4116

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

Facilitymedian $170 · 10th–90th $26–$20,8930%10%10th90th$170Professionalmedian $25 · 10th–90th $24–$310%50%10th90th$25$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
$54.95 / $8,317.64 / $54,954.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $25.12 / $30.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $35.48 / $4,265.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $35.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $190.55 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $39.81 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $38.90 / $100.00
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $204.17 / $309.03
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $56.23 / $64.57
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 / $120.23 / $125.89