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Pennsylvania rates for HCPCS Q4116

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

Facilitymedian $9,120 · 10th–90th $40$75,8580%5%10%10th90th$9,120Professionalmedian $26 · 10th–90th $24$1260%50%10th90th$26$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
$39.81 / $9,772.37 / $75,857.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $25.12 / $30.90
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $338,844.16 / $724,435.96
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $30.90 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $446.68 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.88 / $162.18
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $131.83 / $199.53
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $346.74 / $9,549.93
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $338,844.16 / $707,945.78
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $39.81 / $125.89
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $25.12 / $25.70
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $194.98 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $125.89 / $134.90