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Virginia rates for HCPCS Q4235

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

Facilitymedian $155 · 10th–90th $87–$3310%20%10th90th$155Professionalmedian $91 · 10th–90th $87–$1950%50%10th90th$91$2.0$10.0$50.0$200.0$1.0K$5.0K

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 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $95.50
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $263.03
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $154.88 / $154.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $151.36 / $239.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $95.50 / $169.82
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $109.65
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $186.21 / $891.25
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $186.21 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $154.88 / $204.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $125.89