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Tennessee rates for HCPCS Q4122

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

Facilitymedian $708 · 10th–90th $100–$34,6740%20%10th90th$708Professionalmedian $100 · 10th–90th $95–$1260%50%10th90th$100$100.0$500.0$2.0K$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 / $34,673.69 / $34,673.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $100.00 / $102.33
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $128.82 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $186.21 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $199.53 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $125.89 / $125.89