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Nebraska rates for HCPCS Q4126

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

Facilitymedian $78 · 10th–90th $60–$2240%10%10th90th$78Professionalmedian $62 · 10th–90th $62–$980%50%90th$62$100.0$200.0$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 / $63.10 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $87.10
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $67.61 / $70.79
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $67.61 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $229.09
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 / $89.13 / $120.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $93.33
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $72.44 / $89.13
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $309.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $89.13 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $102.33 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $120.23 / $125.89