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Indiana rates for HCPCS Q4139

AmnioMatrix or BioDMatrix, injectable, 1 cc

Facilitymedian $646 · 10th–90th $427–$8130%20%40%10th90th$646Professionalmedian $646 · 10th–90th $427–$1,8200%50%10th90th$646$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
$645.65 / $645.65 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $1,819.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $812.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $426.58 / $660.69
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63,095.73 / $63,095.73 / $70,794.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $575.44 / $645.65