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Louisiana rates for HCPCS Q4211

Amnion Bio or AxoBioMembrane, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $102 · 10th–90th $0–$1450%20%40%10th90th$102Professionalmedian $120 · 10th–90th $95–$1350%20%40%10th90th$120$0.0$0.1$0.5$2.0$10.0$50.0$200.0

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
$112.20 / $112.20 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $117.49 / $134.90
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.02
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $239.88 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $125.89 / $128.82