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Virginia rates for HCPCS Q4116

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

Facilitymedian $8,913 · 10th–90th $26–$91,2010%20%10th90th$8,913Professionalmedian $26 · 10th–90th $24–$1740%20%40%10th90th$26$2.0$20.0$200.0$2.0K$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
$25.70 / $21,877.62 / $95,499.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $25.12 / $25.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $263.03
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $34.67 / $34.67
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $151.36 / $239.88
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $33.88 / $47.86
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.30 / $30.90 / $57.54
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $25.70 / $30.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.18 / $30.90 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $125.89 / $125.89