go back

Maine rates for HCPCS Q4225

AmnioBind or DermaBind TL, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,479.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $125.89 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,412.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,445.44
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $1,412.54 / $1,819.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $1,412.54 / $1,445.44