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Montana rates for HCPCS Q4229

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

Facilitymedian $209 · 10th–90th $186–$5750%20%40%10th90th$209Professionalmedian $457 · 10th–90th $158–$5370%50%10th90th$457$100.0$200.0$500.0$1.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $575.44 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $575.44
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $309.03
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $309.03
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $478.63 / $776.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $645.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89