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Rhode Island rates for HCPCS Q4221

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

Facilitymedian $263 · 10th–90th $126–$3720%20%10th90th$263Professionalmedian $1,950 · 10th–90th $1,950–$2,1380%20%40%90th$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $2,137.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $281.84 / $371.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,698.24 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $1,949.84