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Minnesota rates for HCPCS Q4123

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

Facilitymedian $102 · 10th–90th $68–$1290%20%40%10th90th$102Professionalmedian $102 · 10th–90th $52–$1260%20%10th90th$102$0.2$1.0$5.0$20.0$100.0$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
$70.79 / $70.79 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $102.33 / $125.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $107.15 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $112.20 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $44.67 / $48.98
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $112.20 / $144.54
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $52.48
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $120.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $125.89 / $239.88