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South Carolina rates for HCPCS Q4235

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

Facilitymedian $117 · 10th–90th $87–$2040%20%10th90th$117Professionalmedian $87 · 10th–90th $87–$1350%50%90th$87$50.0$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
$91.20 / $123.03 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $154.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $125.89 / $147.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $97.72 / $204.17
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $54.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $125.89