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Massachusetts 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 / $87.98 / $87.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.98 / $87.98 / $91.50
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.03 / $117.03 / $420.08
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.98 / $87.98 / $450.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.98 / $87.98 / $87.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.98 / $87.98 / $87.98
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.98 / $132.19 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.76 / $136.76 / $160.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.98 / $87.98 / $87.98
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.03 / $117.03 / $420.08
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.98 / $87.98 / $450.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.42 / $87.98 / $145.52