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North Carolina rates for HCPCS Q4221

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

Facilitymedian $1,585 · 10th–90th $129–$3,3110%10%20%10th90th$1,585Professionalmedian $1,950 · 10th–90th $89–$2,0420%20%10th90th$1,950$1.0$5.0$20.0$100.0$500.0$2.0K$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
$1,445.44 / $1,445.44 / $1,445.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,949.84 / $2,041.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $128.82 / $208.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $190.55 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $169.82
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,949.84 / $2,951.21
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $316.23
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.60 / $194.98 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $2,454.71 / $3,715.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,995.26
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $5,754.40 / $5,754.40
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,585.78 / $7,585.78 / $8,317.64