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MemoDerm, DermaSpan, TranZgraft or InteguPly

Massachusetts 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 Massachusetts, 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 $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 8 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 $85.11
FacilityA hospital or hospital-owned outpatient department$115$93.33 to $182

How much rates vary

Facilitymedian $115 · 10th to 90th $79 to $263Professionalmedian $63 · 10th to 90th $63 to $126
$100$200$500$1K$2K$5Kfacility $115professional $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
$63.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$87.10
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$134.90
Typical High
$707.95
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$223.87
BCBS
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$186.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$229.09
Typical High
$549.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$181.97
Typical High
$1,995.26
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$181.97
Typical High
$275.42
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$104.71
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$134.90
Typical High
$707.95
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$223.87
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$275.42
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$79.43
Typical High
$125.89

Where Massachusetts 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.

Massachusetts· 39th 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.