go back

Missouri rates for HCPCS Q4211

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $117.49 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $117.49 / $134.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $109.65 / $138.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $144.54 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $147.91 / $186.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $125.89 / $125.89