go back

Minnesota rates for HCPCS Q4126

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

Facilitymedian $89 · 10th–90th $62–$2820%20%10th90th$89Professionalmedian $102 · 10th–90th $55–$1260%20%10th90th$102$0.2$1.0$5.0$20.0$100.0$500.0

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 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $89.13 / $100.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $107.15 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $257.04 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $75.86 / $81.28
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $190.55 / $281.84
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $74.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $112.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $83.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $125.89 / $239.88