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Minnesota rates for HCPCS Q4151

AmnioBand or Guardian, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $288 · 10th–90th $138–$4790%20%10th90th$288Professionalmedian $126 · 10th–90th $105–$1380%50%10th90th$126$0.2$1.0$5.0$20.0$100.0$500.0

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
$134.90 / $134.90 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $147.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $288.40 / $288.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $114.82 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $416.87 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $151.36 / $177.83
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $407.38 / $524.81
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $147.91
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $245.47
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $263.03