go back

Nebraska 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 / $536.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$469.20 / $552.00 / $552.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.39 / $552.00 / $552.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.59 / $487.59 / $487.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.17 / $591.96 / $759.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$487.59 / $824.03 / $975.18
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.59 / $487.59 / $979.68
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$395.17 / $591.96 / $759.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.17 / $585.10 / $759.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$463.21 / $487.59 / $536.35