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New Hampshire rates for HCPCS Q4141

AlloSkin AC, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $129 · 10th–90th $107–$2510%20%10th90th$129Professionalmedian $107 · 10th–90th $107–$1320%50%90th$107$50.0$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
$107.15 / $128.82 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $131.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $251.19 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $107.15 / $125.89
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $144.54 / $162.18