go back

Utah rates for HCPCS Q4227

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,360.17 / $1,360.17 / $1,360.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,172.56 / $1,289.81 / $1,465.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.65 / $1,389.38 / $2,837.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,172.56 / $1,172.56 / $1,172.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,172.56 / $1,172.56 / $1,172.56