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MemoDerm, DermaSpan, TranZgraft or InteguPly

Maine 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 Maine, July 2026.

Insurers have agreed to pay about $63.10 for this service. Most negotiated rates run $63.10 to $64.57.

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.

How much rates vary

Facilitymedian $145 · 10th to 90th $145 to $363Professionalmedian $63 · 10th to 90th $63 to $102
$100$200facility $145professional $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. Small sample; interpret with caution. 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
$64.57
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$83.18
Typical High
$83.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$363.08
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$75.86
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$120.23
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$83.18
Typical High
$125.89

Where Maine 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.

Maine· 43rd 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.