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Nebraska rates for HCPCS Q4123

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

Facilitymedian $71 · 10th–90th $71–$2040%20%40%90th$71Professionalmedian $71 · 10th–90th $71–$1200%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
$70.79 / $70.79 / $70.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $120.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $77.62 / $81.28
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $77.62 / $81.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $85.11 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $85.11 / $134.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $85.11
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $81.28 / $85.11
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $309.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $81.28 / $177.83
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $28.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $102.33 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $120.23 / $125.89