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New Hampshire rates for HCPCS Q4178

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

Facilitymedian $107 · 10th–90th $89–$2510%20%10th90th$107Professionalmedian $89 · 10th–90th $89–$1260%50%90th$89$100.0$200.0

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
$89.13 / $107.15 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $112.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $251.19 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $125.89 / $125.89
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $144.54 / $162.18