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Massachusetts rates for HCPCS Q4122

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

Facilitymedian $135 · 10th–90th $102$7080%20%10th90th$135Professionalmedian $102 · 10th–90th $95$1260%50%10th90th$102$50.0$200.0$1.0K$5.0K$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
$102.33 / $102.33 / $54,954.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $100.00 / $120.23
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $707.95
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $398.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $269.15 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $181.97 / $2,951.21
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $181.97 / $257.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $125.89
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19,952.62 / $19,952.62 / $19,952.62
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $707.95
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $199.53 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $109.65 / $125.89