go back

Massachusetts rates for HCPCS Q4188

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.59 / $487.59 / $487.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $507.09
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$833.00 / $833.00 / $1,530.45
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $2,386.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.59 / $487.59 / $487.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $487.59
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.59 / $732.60 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $487.59
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $487.59
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$833.00 / $833.00 / $1,530.45
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $2,386.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $832.73