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Arizona rates for HCPCS Q4221

Amnio Wrap2, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $2,512 · 10th–90th $1,413–$8,7100%5%10%10th90th$2,512Professionalmedian $1,950 · 10th–90th $135–$2,4550%20%40%10th90th$1,950$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,344.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $3,235.94 / $10,471.29
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,884.03 / $5,011.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,238.72 / $4,365.16
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,398.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $3,311.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,995.26