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Georgia rates for HCPCS Q4126

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

Facilitymedian $123 · 10th–90th $62–$3390%20%10th90th$123Professionalmedian $65 · 10th–90th $62–$1170%20%10th90th$65$1.0$5.0$20.0$100.0

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
$61.66 / $61.66 / $61.66
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $87.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $87.10 / $93.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $234.42 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $138.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $128.82 / $204.17
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $194.98 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $123.03 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $125.89 / $125.89