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Nebraska rates for HCPCS Q4235

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

Facilitymedian $120 · 10th–90th $81–$2240%10%10th90th$120Professionalmedian $87 · 10th–90th $87–$1230%50%90th$87$100.0$200.0$500.0

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
$87.10 / $87.10 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $104.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $95.50 / $100.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $95.50 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $208.93 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $144.54
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $125.89 / $162.18
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $114.82
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $109.65 / $141.25
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $309.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $141.25 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $114.82 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $125.89