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Alaska rates for HCPCS Q4123

AlloSkin RT, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $105 · 10th–90th $19–$1780%10%20%10th90th$105Professionalmedian $74 · 10th–90th $71–$3020%50%10th90th$74$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $79.43 / $177.83
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $302.00 / $512.86
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $144.54 / $229.09
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $114.82 / $125.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.50 / $85.11 / $177.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $125.89 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $107.15 / $316.23