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Derma-Gide

Pennsylvania rates for HCPCS Q4203

Derma-Gide, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does Derma-Gide cost?

$1,047

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $1,047 for this service. The price depends on where it is billed: about $1,047 from a physician practice, and about $1,047 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 8 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$1,047$1,047 to $1,072
FacilityA hospital or hospital-owned outpatient department$1,047$692 to $1,072

How much rates vary

Facilitymedian $1,047 · 10th to 90th $214 to $1,072Professionalmedian $1,047 · 10th to 90th $126 to $1,096
$200$1K$5K$20Kfacility $1,047professional $1,047

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
$1,047.13
Median
$1,047.13
Typical High
$1,071.52
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,096.48
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$831.76
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$831.76
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
$154.88
Median
$275.42
Typical High
$851.14
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$158.49
Typical High
$223.87
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,071.52
Typical High
$1,071.52
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,047.13
Typical High
$1,096.48
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$257.04
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$229.09
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$741.31

Where Pennsylvania sits

The same service costs 5.0 times more in California than in Minnesota. 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· 23rd of 51

$1,047

CA $1,072MN $214

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.