go back

Massachusetts rates for HCPCS Q4123

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.55 / $71.55 / $71.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $74.41
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.05 / $75.13 / $233.40
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $364.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.77 / $87.86 / $161.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.55 / $71.55 / $71.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $71.55
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.55 / $107.50 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.16 / $103.16 / $121.36
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $71.55
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.18 / $104.18 / $202.50
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $364.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.55 / $71.55 / $118.35