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MemoDerm, DermaSpan, TranZgraft or InteguPly

Louisiana 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?

$63.10

Typical negotiated rate. In Louisiana, July 2026.

Insurers have agreed to pay about $63.10 for this service. The price depends on where it is billed: about $63.10 from a physician practice, and about $66.07 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 5 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$63.10$63.10 to $74.13
FacilityA hospital or hospital-owned outpatient department$66.07$64.57 to $66.07

How much rates vary

Facilitymedian $66 · 10th to 90th $63 to $126Professionalmedian $63 · 10th to 90th $63 to $126
$100$200facility $66professional $63

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
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$64.57
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$74.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Christus
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$239.88
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
United
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$125.89
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$125.89
Typical High
$128.82

Where Louisiana 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.

Louisiana· 48th of 51

$63.10

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.