go back

AlloSkin RT

North Carolina rates for HCPCS Q4123

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

Rates data updated July 2026.

Facilitymedian $28 · 10th–90th $13$1740%10%20%10th90th$28Professionalmedian $72 · 10th–90th $22$1260%20%10th90th$72$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
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$22.39
Typical High
$22.39
Aetna
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$70.79
Typical High
$75.86
BCBS
Setting
Facility
Modifier
Global
Typical Low
$13.49
Median
$13.49
Typical High
$26.30
BCBS
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$91.20
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$190.55
Typical High
$302.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Medcost
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$70.79
Typical High
$125.89
Medcost
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$208.93
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$125.89
Typical High
$125.89
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$707.95
Typical High
$707.95
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69