go back

AmnioArmor

Wisconsin rates for HCPCS Q4188

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

Rates data updated July 2026.

Facilitymedian $708 · 10th–90th $389$1,8200%10%20%10th90th$708Professionalmedian $490 · 10th–90th $126$1,8200%10%20%10th90th$490$5.0$20.0$100.0$500.0$2.0K$10.0K

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
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$501.19
Typical High
$501.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$501.19
Typical High
$537.03
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,698.24
Typical High
$2,818.38
Cigna
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$1,096.48
Typical High
$1,621.81
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$223.87
Typical High
$501.19
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$501.19
Typical High
$1,096.48
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$380.19
Medica
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$501.19
Typical High
$1,096.48
Medica
Setting
Professional
Modifier
Global
Typical Low
$489.78
Median
$489.78
Typical High
$1,023.29
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$58.88
Typical High
$70.79
Network Health
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$1,047.13
Typical High
$1,047.13
Network Health
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$363.08
Typical High
$588.84
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$501.19
Typical High
$1,096.48
Quartz
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$275.42
Typical High
$446.68
Quartz
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$831.76
Typical High
$2,187.76
Quartz
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$144.54
Typical High
$1,949.84
Security Health
Setting
Professional
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$812.83
United
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$165.96