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South Carolina rates for HCPCS Q4139

AmnioMatrix or BioDMatrix, injectable, 1 cc

Facilitymedian $646 · 10th–90th $646–$1,5490%50%90th$646Professionalmedian $646 · 10th–90th $646–$1,8200%50%90th$646$50.0$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
$645.65 / $645.65 / $645.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $1,819.70
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $707.95 / $1,819.70
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $446.68 / $630.96