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Texas rates for HCPCS Q4123

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

Facilitymedian $85 · 10th–90th $71$7080%20%40%10th90th$85Professionalmedian $72 · 10th–90th $71$1260%50%10th90th$72$2.0$10.0$50.0$200.0$1.0K

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 / $72.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $77.62
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $120.23 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $302.00 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $72.44 / $154.88
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $75.86 / $218.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $37.15 / $70.79
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $25.70 / $28.18
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $72.44 / $194.98
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $102.33 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $125.89
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $125.89 / $125.89