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Florida rates for HCPCS Q4122

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

Facilitymedian $17,783 · 10th–90th $100–$56,2340%10%20%10th90th$17,783Professionalmedian $100 · 10th–90th $95–$1260%50%10th90th$100$1.0$10.0$100.0$1.0K$10.0K

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
$100.00 / $17,782.79 / $56,234.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $100.00 / $104.71
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $107.15 / $125.89
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $107.15 / $131.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $102.33 / $141.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $39.81 / $50.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $120.23 / $199.53
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $125.89 / $125.89
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $128.82