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Arkansas rates for HCPCS Q4142

XCM biologic tissue matrix, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $93 · 10th–90th $93–$2400%50%90th$93Professionalmedian $120 · 10th–90th $83–$1380%20%10th90th$120$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $120.23 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $173.78 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $125.89