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MemoDerm, DermaSpan, TranZgraft or InteguPly

New York 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?

$77.62

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $77.62 for this service. The price depends on where it is billed: about $81.28 from a physician practice, and about $63.10 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$81.28$63.10 to $87.10
FacilityA hospital or hospital-owned outpatient department$63.10$63.10 to $126

How much rates vary

Facilitymedian $63 · 10th to 90th $63 to $186Professionalmedian $81 · 10th to 90th $63 to $126
$100$1K$10Kfacility $63professional $81

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
$66.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$91.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$165.96
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$151.36
Typical High
$338.84
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$83.18
Typical High
$239.88
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$64.57
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$64.57
Typical High
$64.57
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$64.57
Typical High
$112.20
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$138.04
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$85.11
Typical High
$141.25
Univera
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$69.18
Univera
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$64.57
Typical High
$64.57

Where New York 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.

New York· 10th of 51

$77.62

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.