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New Hampshire rates for HCPCS Q4139

AmnioMatrix or BioDMatrix, injectable, 1 cc

Facilitymedian $1,820 · 10th–90th $1,820–$2,1880%50%90th$1,820Professionalmedian $646 · 10th–90th $295–$1,8200%20%10th90th$646$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,819.70 / $1,819.70 / $2,187.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,819.70 / $1,819.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $616.60 / $1,071.52
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $3,981.07