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Massachusetts rates for HCPCS Q4150

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

Facilitymedian $126 · 10th–90th $78–$7080%20%10th90th$126Professionalmedian $78 · 10th–90th $78–$1260%50%90th$78$100.0$500.0$2.0K$10.0K$50.0K

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 / $77.62 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $91.20
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $134.90 / $707.95
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $269.15 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $177.83 / $6,918.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $125.89
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $134.90 / $707.95
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $125.89 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $138.04 / $177.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $83.18 / $125.89