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Arizona rates for HCPCS Q4150

AlloWrap DS or dry, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $138 · 10th–90th $81–$3390%10%20%10th90th$138Professionalmedian $79 · 10th–90th $78–$1260%20%40%10th90th$79$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
$138.04 / $138.04 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $97.72
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $131.83 / $426.58
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $117.49 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $95.50 / $190.55
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $89.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $125.89