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Virginia rates for HCPCS Q4123

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

Facilitymedian $76 · 10th–90th $71–$1550%50%10th90th$76Professionalmedian $72 · 10th–90th $71–$1260%50%10th90th$72$2.0$10.0$50.0$200.0

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 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $104.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $147.91
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $16.22 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $131.83 / $239.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $75.86 / $128.82
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $109.65
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $85.11 / $104.71
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $85.11 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $125.89 / $125.89