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North Dakota rates for HCPCS Q4126

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

Facilitymedian $62 · 10th–90th $60–$1050%50%10th90th$62Professionalmedian $62 · 10th–90th $58–$790%50%10th90th$62$50.0$100.0$200.0

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 / $72.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $58.88 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $81.28 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $83.18 / $112.20
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $67.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $239.88