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Indiana rates for HCPCS Q4150

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

Facilitymedian $257 · 10th–90th $79–$5130%10%10th90th$257Professionalmedian $78 · 10th–90th $78–$1260%50%90th$78$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
$77.62 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $81.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $288.40 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $125.89
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $93.33 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $346.74 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $125.89 / $125.89