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Wisconsin rates for HCPCS Q4229

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

Facilitymedian $501 · 10th–90th $331–$2,2910%20%10th90th$501Professionalmedian $457 · 10th–90th $126–$5130%20%40%10th90th$457$5.0$20.0$100.0$500.0$2.0K

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
$478.63 / $478.63 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $173.78 / $416.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $1,949.84 / $3,388.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $223.87 / $645.65
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $478.63 / $1,047.13
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $338.84 / $1,412.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $1,659.59
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $60.26 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $549.54
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $549.54 / $891.25
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $245.47 / $446.68
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $1,412.54 / $2,290.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $478.63 / $3,090.30
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $758.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $1,174.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $501.19