go back

Missouri rates for HCPCS Q4221

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

Facilitymedian $2,042 · 10th–90th $129–$3,6310%10%20%10th90th$2,042Professionalmedian $1,950 · 10th–90th $110–$2,2910%20%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
$1,949.84 / $2,041.74 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,344.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $120.23 / $1,905.46
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $141.25 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $239.88 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $151.36
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,344.23 / $5,623.41
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,949.84 / $6,760.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $2,691.53 / $2,951.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $125.89 / $1,995.26