go back

AlloWrap DS or Dry

Pennsylvania rates for HCPCS Q4150

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

Rates data updated July 2026.

How much does AlloWrap DS or Dry cost?

$79.43

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $79.43 for this service. The price depends on where it is billed: about $79.43 from a physician practice, and about $79.43 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$79.43$77.62 to $81.28
FacilityA hospital or hospital-owned outpatient department$79.43$77.62 to $117

How much rates vary

Facilitymedian $79 · 10th to 90th $78 to $447Professionalmedian $79 · 10th to 90th $78 to $126
$100$200$500facility $79professional $79

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$79.43
Aetna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$81.28
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$77.62
Typical High
$97.72
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$446.68
Typical High
$478.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$263.03
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$151.36
Typical High
$218.78
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$5,128.61
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$79.43
Typical High
$79.43
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$81.28
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$87.10
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$87.10
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$125.89
Typical High
$141.25

Where Pennsylvania sits

The same service costs 1.9 times more in Alaska than in Washington, DC. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 35th of 51

$79.43

AK $145DC $77.62

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.