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Nebraska 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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,452.73 / $3,549.39 / $6,139.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$640.00 / $1,056.00 / $1,216.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,146.04 / $1,146.04 / $1,146.04
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,146.04 / $1,146.04 / $1,146.04
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,146.04 / $1,146.04 / $1,146.04