go back

Indiana rates for HCPCS Q4139

AmnioMatrix or BioDMatrix, injectable, 1 cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$640.00 / $640.00 / $640.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$640.00 / $640.00 / $987.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$424.92 / $424.92 / $820.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.42 / $424.92 / $586.38
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.71 / $50.71 / $65.73
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.71 / $60.85 / $76.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.89 / $560.89 / $560.89