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DermACELL, DermACELL AWM or DermACELL AWM Porous

Alaska rates for HCPCS Q4122

DermACELL, DermACELL AWM or DermACELL AWM Porous, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated October 2026.

How much does DermACELL, DermACELL AWM or DermACELL AWM Porous cost?

$162

Typical negotiated rate. In Alaska, October 2026.

Insurers have agreed to pay about $162 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $257 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$162$162 to $191
FacilityA hospital or hospital-owned outpatient department$257$170 to $316

How much rates vary

Facilitymedian $257 · 10th to 90th $129 to $550Professionalmedian $162 · 10th to 90th $120 to $316
$100$200$500$1Kfacility $257professional $162

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Aetna
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$162.18
Typical High
$162.18
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$50.12
Median
$81.28
Typical High
$81.28
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$19.95
Median
$32.36
Typical High
$32.36
Aetna
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$15.14
Median
$24.55
Typical High
$24.55
Aetna
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$10.00
Median
$16.22
Typical High
$16.22
Cigna
Setting
Facility
Modifier
None
Typical Low
$186.21
Median
$316.23
Typical High
$933.25
Cigna
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$162.18
Typical High
$234.42
Moda Health
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$162.18
Typical High
$416.87
Moda Health
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$81.28
Median
$81.28
Typical High
$81.28
Moda Health
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$32.36
Median
$32.36
Typical High
$32.36
Moda Health
Setting
Professional
Modifier
55 · Aftercare only
Typical Low
$24.55
Median
$24.55
Typical High
$24.55
Moda Health
Setting
Professional
Modifier
56 · Pre-op care only
Typical Low
$16.22
Median
$16.22
Typical High
$16.22
Premera BCBS
Setting
Facility
Modifier
None
Typical Low
$102.33
Median
$194.98
Typical High
$407.38
Premera BCBS
Setting
Professional
Modifier
None
Typical Low
$114.82
Median
$120.23
Typical High
$144.54
Providence
Setting
Facility
Modifier
None
Typical Low
$128.82
Median
$302.00
Typical High
$933.25
Providence
Setting
Professional
Modifier
None
Typical Low
$60.26
Median
$125.89
Typical High
$138.04
United
Setting
Professional
Modifier
None
Typical Low
$125.89
Median
$190.55
Typical High
$346.74

Where Alaska sits

The same service costs 4.4 times more in North Dakota than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Alaska· 3rd of 51

$162

ND $182KY $41.69

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.