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Massachusetts rates for HCPCS Q4188

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

Facilitymedian $490 · 10th–90th $151–$2,1880%50%10th90th$490Professionalmedian $490 · 10th–90th $191–$5370%50%10th90th$490$100.0$500.0$2.0K$10.0K$50.0K

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
$489.78 / $489.78 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $537.03
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $269.15 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $177.83 / $6,918.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $489.78
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $977.24 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $489.78 / $812.83