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North Carolina rates for HCPCS Q4122

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

Facilitymedian $120 · 10th–90th $32$18,6210%20%10th90th$120Professionalmedian $102 · 10th–90th $95$1200%50%10th90th$102$0.1$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
$102.33 / $18,620.87 / $64,565.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $100.00 / $102.33
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $32.36 / $53.70
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $114.82 / $114.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $120.23 / $173.78
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $316.23
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
$102.33 / $154.88 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $125.89 / $128.82
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69