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MemoDerm, DermaSpan, TranZgraft or InteguPly

Alaska rates for HCPCS Q4126

MemoDerm, DermaSpan, TranZgraft or InteguPly, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does MemoDerm, DermaSpan, TranZgraft or InteguPly cost?

$126

Typical negotiated rate. In Alaska, July 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $115 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$63.10 to $309
FacilityA hospital or hospital-owned outpatient department$115$69.18 to $158

How much rates vary

Facilitymedian $115 · 10th to 90th $63 to $214Professionalmedian $126 · 10th to 90th $63 to $407
$100$200$500$1K$2Kfacility $115professional $126

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$100.00
Typical High
$165.96
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$302.00
Typical High
$512.86
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$138.04
Typical High
$213.80
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$107.15
Typical High
$117.49
Providence
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$114.82
Typical High
$302.00
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$125.89
Typical High
$125.89
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$190.55
Typical High
$380.19

Where Alaska sits

The same service costs 2.0 times more in Alaska than in Arkansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Alaska· 1st of 51

$126

AK $126AR $63.10

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.