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Michigan rates for HCPCS Q4221

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

Facilitymedian $2,042 · 10th–90th $102–$3,3110%50%10th90th$2,042Professionalmedian $1,950 · 10th–90th $1,445–$2,1380%20%40%10th90th$1,950$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$2,041.74 / $2,041.74 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $2,187.76
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,691.53 / $7,413.10
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $2,041.74 / $3,311.31
Priority Health
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 / $3,311.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,995.26