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Minnesota 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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $1.00 / $142.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.38 / $80.48 / $147.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.58 / $383.30 / $538.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.68 / $120.89 / $147.00
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.25 / $351.27 / $485.50
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.71 / $96.71 / $131.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.48 / $80.48 / $177.50
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.48 / $80.48 / $184.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.98 / $87.98 / $158.36