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Arizona rates for HCPCS Q4235

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $95.50 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $123.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $134.90 / $331.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $138.04 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $95.50 / $177.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $95.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $154.88 / $154.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $95.50 / $125.89