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Indiana rates for HCPCS Q4123

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

Facilitymedian $214 · 10th–90th $72–$5130%10%10th90th$214Professionalmedian $71 · 10th–90th $71–$1260%50%90th$71$20.0$50.0$100.0$200.0$500.0

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
$72.44 / $72.44 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $77.62
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $234.42 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $114.82
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $85.11 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $346.74 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $125.89 / $125.89