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Massachusetts rates for HCPCS Q4123

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

Facilitymedian $102 · 10th–90th $71–$2400%20%10th90th$102Professionalmedian $71 · 10th–90th $71–$1260%50%90th$71$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$70.79 / $70.79 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $85.11
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $70.79 / $707.95
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $263.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $269.15 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $181.97 / $2,951.21
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $181.97 / $257.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $120.23
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $70.79 / $707.95
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $263.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $117.49 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $70.79 / $125.89