go back

AlloSkin RT

Wisconsin rates for HCPCS Q4123

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

Rates data updated July 2026.

Facilitymedian $105 · 10th–90th $71$4900%20%10th90th$105Professionalmedian $87 · 10th–90th $71$3020%20%10th90th$87$5.0$20.0$100.0$500.0$2.0K

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
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$74.13
Typical High
$85.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$87.10
Typical High
$407.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$123.03
Typical High
$199.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$38.02
Median
$125.89
Typical High
$223.87
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$158.49
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$29.51
Median
$29.51
Typical High
$32.36
Medica
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$74.13
Typical High
$162.18
Medica
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$398.11
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$70.79
Network Health
Setting
Facility
Modifier
Global
Typical Low
$39.81
Median
$39.81
Typical High
$39.81
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$158.49
Quartz
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$204.17
Typical High
$416.87
Quartz
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$707.95
Quartz
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$660.69
Security Health
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$95.50
Typical High
$117.49
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$144.54