go back

Minnesota 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 / $502.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $519.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.07 / $472.96 / $487.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,105.40 / $2,031.34 / $2,855.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.87 / $502.31 / $610.80
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$981.75 / $1,861.59 / $2,572.96
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.85 / $401.85 / $546.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.59 / $487.59 / $1,074.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $1,118.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $883.90