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Missouri rates for HCPCS Q4150

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

Facilitymedian $102 · 10th–90th $78–$2400%20%10th90th$102Professionalmedian $83 · 10th–90th $78–$1290%20%40%10th90th$83$50.0$100.0$200.0

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 / $93.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $109.65 / $131.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $144.54 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $239.88 / $302.00
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 / $102.33 / $239.88
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $85.11 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $109.65 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $125.89 / $125.89