go back

Louisiana 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
$87.98 / $88.86 / $90.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.98 / $88.86 / $96.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.42 / $104.42 / $156.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.42 / $104.42 / $106.51
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.37 / $121.37 / $121.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.00 / $83.00 / $87.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.98 / $87.98 / $87.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.60 / $87.98 / $114.18